American College of Clinical Pharmacy
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ACCP Report - December 2012

Pharmacist Organizations Partner to Seek Specialty Recognition for Pediatric and Critical Care Pharmacy Specialties

ACCP, the American Pharmacists Association (APhA), and the American Society of Health-System Pharmacists (ASHP) have partnered to submit petitions to the Board of Pharmacy Specialties (BPS) in seeking recognition of both critical care pharmacy practice and pediatric pharmacy practice as specialties in pharmacy. These three organizations were joined by the Pediatric Pharmacy Advocacy Group (PPAG) as a full partner in preparing and submitting the pediatrics petition.

For each petition, the sponsoring organizations provided a detailed case for specialty recognition according to the criteria established by BPS. For pediatrics, the petition describes the complex and unique needs of pediatric patients, who require highly individualized care because of varying ages, weights, and developmental stages. Board recognition is essential because the health challenges facing today’s pediatric patients are not being adequately addressed by pharmacists in general practice or other specialty practices, according to the organizations in their petition to BPS. The number of pharmacists who devote most of their time to pediatric pharmacy practice is estimated to be between 4000 and 5000 practitioners.

About 70% of all pediatric hospital bed-days are for chronic illnesses. In 2006, around 14% of U.S. children were reported to have special health care needs, and 22% of households with children had at least one child with a special health care need. Although the needs are substantial and diverse in pediatrics, the Children’s Hospital Association has reported that shortages of pediatric care mean that many young patients must wait weeks and sometimes months to get an appointment. In a nationwide survey of rural hospitals, more than 36% responded that they were experiencing a shortage of pediatric providers within all disciplines.

For the critical care petition, the three organizations provided a detailed case for specialty recognition by citing the highly complex needs of critically ill or critically injured patients who require intensive care, usually with life-and-death consequences. The petitioners urged board recognition because the complexity of critical illnesses requires that patients have access to the expertise of a critical care pharmacist specialist who brings a deep understanding of how drugs function and interact in critically ill patients. The number of pharmacists who devote most of their time to critical care pharmacy practice is estimated to be between 4000 and 5000.

Each year in the United States, 5 million patients of all ages become critically ill or are critically injured and require intensive care through medical, surgical, or specialty intensive care units in hospitals, trauma centers, and health systems. Medication management of these patients requires the application of specialized knowledge and skill across a wide range of disease states, which often present at the most extreme ends of the spectrum. These skills must be coupled with an in-depth understanding of the clinical and pathophysiologic differences between critically and noncritically ill patients, as well as the management of common disease states under uncommon circumstances.

BPS held an open hearing for both petitions on Tuesday, December 4, at the ASHP Midyear Clinical Meeting in Las Vegas. This open hearing was part of BPS’s public comment period, soliciting input from the pharmacy profession, other health professions, third-party payers, and the public in support of or opposition to these petitions. BPS will consider the comments from this hearing in its deliberations, together with the evidence presented by the petitioning organizations, to determine whether the criteria for recognizing a new pharmacy specialty have been met.

The petitions and related information on the comment process may be viewed on the BPS Web site ( In addition, the petitions may be viewed on the ACCP Web site at:

To learn more about ACCP’s efforts to increase pharmacy specialty recognition, visit