ABSTRACT
Earlier chapters, especially Chapters 9 and 10, show that the quality of drug therapy can be improved on the patient and provider levels, perhaps with no increase in overall expenditures for care. The theoretical and empirical evidence show an economically feasible way to improve the quality of drug therapy. Establishing pharmaceutical care systems, however feasible, will not be simple. The bright picture of systematically managed drug therapy for individual patients, described in Chapter 10, is incomplete. Drug therapy is an intimate part of health care delivery. It is probably unlikely that the “second drug problem” can be ameliorated without farreaching changes in health care delivery, at all four of the levels enumerated by the Institute of Medicine: patient, provider, organization, and environment.5 It is possible, however, that slow development of medications management systems could retard, or at the least lag behind, development of safer and more effective health care delivery systems.
