The primary objectives of the article were accomplished by providing both a bibliography of articles dealing with clinical pharmacy services in acute-care facilities and summaries of those constituting original research reports on clinical pharmacy services. However, in the process, we made the following interesting observations. We found that articles reporting impacts on cost, quality, and attitude numbered 48, 58, and 24, respectively. Most articles relating to drug therapy monitoring, with minor exceptions, dealt with either the quality or cost-savings impact or a combination of both. Also, articles concerning drug therapy monitoring comprised almost half of all those summarized (40 articles). Articles detailing drug information and education (category 2) numbered 28 and dealt mainly with attitudes or quality impacts with minor reference to cost-savings. It was also interesting, albeit expected, to observe that the bulk of attitudinal studies fell in category 2. We found category 5, controlling medication administration, had 13 articles, primarily concerned with cost and or quality. Category 4, reporting and detection of adverse drug reactions, contained a total of eight articles mainly studying the impact on quality. The other categories contained very few, if any, articles. From these results, it is evident that the profession has made significant strides in building a strong scientific data base to support the value of its clinical services. However, there is ample room for additional original research reports. Although it can be argued that alone many of the studies could not justify clinical pharmacy as cost-effective, organized as one reference they provide an invaluable resource. Although it might be unreasonable to expect each pharmacy department to be able to cost-justify its existence, this work presents the background data needed to begin or develop such efforts.

Since 2004, passing the North American Pharmacist Licensure Examination (NAPLEX) has been a requirement for earning initial pharmacy licensure in all 50 United States. The creation and evolution from 1952-2005 of the particular pharmacy competency testing areas and quantities of questions are described for the former paper-and-pencil National Association of Boards of Pharmacy Licensure Examination (NABPLEX) and the current candidate-specific computer adaptive NAPLEX pharmacy licensure examinations. A 40% increase in the weighting of NAPLEX Blueprint Area 2 in May 2005, compared to that in the preceding 1997-2005 Blueprint, has implications for candidates' NAPLEX performance and associated curricular content and instruction. New pharmacy graduates' scores on the NAPLEX are neither intended nor validated to serve as a criterion for assessing or judging the quality or effectiveness of pharmacy curricula and instruction. The newest cycle of NAPLEX Blueprint revision, a continual process to ensure representation of nationwide contemporary practice, began in early 2008. It may take up to 2 years, including surveying several thousand national pharmacists, to complete.

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State boards of pharmacy strive to reshape state regulation of wholesale distributors to maintain the security and integrity of the US medication distribution system. Despite being faced with a complicated situation of illegal importation of drugs, erosion of state and national borders, and a complete disregard for US federal and state laws by entities engaged in the production and distribution of counterfeit drugs, the National Association of State Boards of Pharmacy (NABP) and state boards of pharmacy are working to develop and implement more stringent laws and regulations for the licensure and regulation of wholesale distributors. In citing incidences of counterfeit drugs from a global perspective and efforts that NABP has taken to implement the Prescription Drug Marketing Act of 1988, this discussion will highlight NABP’s recent efforts to monitor counterfeit and adulterated drugs entering the US drug distribution system, recommendations emanating from NABP’s Task Force on Counterfeit Drugs and Pedigree Requirements, and its Verified-Accredited Wholesale Distributors program.

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