Overburdened pharmacists at top retail chains say they worry about patient safety

More tasks and fewer pharmacists are causing more medication errors at some of the country's largest retail pharmacy chains, including CVS, Walgreens and Rite Aid, according to a report from The New York Times.

The Times collected anonymous pharmacists' letters to state pharmacy boards and conducted interviews with pharmacists at the country's top retail pharmacy chains and found that many are concerned that a focus on unrealistic metrics is making it too hard to do their jobs safely and causing more medication errors. 

Medication errors include giving a patient the wrong dose of a drug or the wrong drug.

Pharmacists at retail pharmacy chains are often expected to not only fill prescriptions, but to give flu shots, work drive-thru pharmacy windows, counsel patients, call physicians and insurance companies and meet corporate performance metrics, such as switching a certain number of patients to 90-day refills. 

The industry faces pressure as drug reimbursement rates are declining and consolidation has left just a few chains dominating the market.

"I am a danger to the public working for CVS," a pharmacist wrote in an anonymous letter to the Texas State Board of Pharmacy obtained by the Times

The chief executive of the Florida Pharmacy Association told the Times the number of complaints from pharmacists about staff cuts at pharmacies and concerns over patient safety was "overwhelming" last year. 

But the National Association of Chain Drug Stores told the Times it's wrong to "assume cause-effect relationships" between medication errors and pharmacists' workloads.

There aren't strict reporting requirements for medication errors, and often mistakes don't become public because companies will reach a settlement with affected patients which tend to include a confidentiality agreement. The last comprehensive study of medication errors was in 2006, according to the Times

Some states have created laws such as mandatory lunch breaks for pharmacists or limiting the number of technicians pharmacists are required to supervise, but they aren't always followed, can be difficult to enforce or don't address the bigger problems. 

CVS defended itself in a news release, saying "we fundamentally disagree with the recent assertion in The New York Times that patient safety is at risk in America’s pharmacies."

"Patient safety is our highest priority. Everyone at CVS Health, including our more than 30,000 pharmacists, approaches this responsibility with the utmost seriousness and dedication," the company said. 

In a statement to Becker's Hospital Review, Walgreens said:  "We make it clear to all pharmacists that they should never work beyond what they believe is advisable, in their professional judgment."

"Ensuring that we are providing high quality and trusted pharmacy services to meet the needs of our customers, while also ensuring the well-being of each of our pharmacy staff members, are critical factors in determining staffing needs across our pharmacies," the company said.

Becker's has also reached out to Rite Aid for comment and will update this story accordingly.

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