Download Pharmacist Interventions and Healthcare Utilization and Cost

Pharmacist Interventions and
Healthcare Utilization and Cost
Amanda Lewis, Natasha Gregory, Ernest McDonald, Juan
Sotolongo, Grashma Vadakkel, Lalita Rayaprolu
Objective
Need for pharmacist interventions
Reduce healthcare utilization and cost
Provide evidence based information
The Importance of Pharmacist Interventions
“...enhanced role of advocating for proper use of medications to avoid medication
errors and achieve desired outcomes.”
Decreasing health care cost and utilization
Medication adherence
Patient education
Effective communication & establishing patient relationships
Medication therapy management
Being a member of a healthcare team
Reducing Healthcare Utilization:
Physician
Drug therapy consultant
Patient/doctor drug therapy liaison
Reduce drug related litigation events
Well visits
Community setting
Follow-ups
Reducing Healthcare Utilization:
Hospitalizations & ED Visits
● Medication errors occurred in
5.22% of patients admitted to
hospitals.
● In 2008 it was estimated that
hospital medication errors
cost over $17.1 billion.
● How can pharmacists help
reduce these numbers?
Reducing Healthcare Utilization:
Cost
One year evaluation of 5 healthcare teams
3 teams included pharmacist
Average cost saving for team that include
pharmacist- 377$ per inpatient admission
Increase in medication adherence
Lower on average LOS
Benefit-to-Cost Ratio 6.03:1
Pharmacist provide population-based
pharmaceutical care
Switches to generic medications and
switches from RX to OTC
Disease management programs
Negotiations with health plans and P/A
Implemented EHR
Patients with controlled BP increased from
45-60%
Saved 450,000$ in inpatient cost for DVT
Evidence-base Interventions:
Reduce patient mortality
The role of the clinical pharmacist in reducing mortality in
hospitalized cardiac patients: A prospective, nonrandomized
controlled trial using propensity score methods
Results
Pharmacist intervention caused all cause mortality to fall from 1.8% and 1.1%.
There was no statistical difference in the control group.
Conclusion
Pharmacist identified drug related problems, and physician’s correction of a
drug-related problem after pharmacist advice caused a significant decrease
in all-cause mortality in cardiac patients.
Evidence-based Interventions:
Hospital Length of Stay
Clinical pharmacists and inpatient medical care
Results:
Of the 36 studies reviewed, there was a shortened length of stay in 9 of the studies.
Reductions seen in adverse drug events and medication errors
Improvements seen in medication adherence and knowledge
Conclusion:
Implementing a clinical pharmacist in an inpatient setting greatly improved care without any harm
Summary
Reduce healthcare utilization by corresponding with physicians and providing
different services (ex: drug therapy consultations)
Decrease the amount of medication errors, ultimately decreasing hospital
admissions and lengths of stay, and patient mortality
Incorporating pharmacists as part of a patient’s healthcare team, can reduce
cost
In terms of the future:
Studies with a larger sample size, reproducible interventions and identifying patient-specific
factors that led to improved outcomes
References
1.
Kelly W, Peterson A. Leadership and Management if Pharmacy Practice. CRC Press, 2015.
2.
American Society of Hospital Pharmacists. ASHP guidelines on preventing medication errors in hospitals. Am J Hosp
Pharm. 1993; 50:305–14.
3.
Bond, C. A., Raehl, C. L. and Franke, T. (2002), Clinical Pharmacy Services, Hospital Pharmacy Staffing, and
Medication Errors in United States Hospitals. Pharmacotherapy, 22: 134–147. doi: 10.1592/phco.22.3.134.33551
4.
Bjornson DC, Hiner WO, Potyk RP, et al. Effect of pharmacists on health care outcomes in hospitalized patients. Am
J Hosp Pharm. 1993;50(9):1875-84.
5.
Devine EB, Hoang S, Fisk AW, Wilson-norton JL, Lawless NM, Louie C. Strategies to optimize medication use in the
physician group practice: the role of the clinical pharmacist. J Am Pharm Assoc (2003). 2009;49(2):181-91.
6.
Zhai XB, Tian DD, Liu XY. The role of the clinical pharmacist in reducing mortality in hospitalized cardiac patients: A
prospectve, nonrandomized controlled trial using propensity score methods. Int J Clin Pharamcol Ther. 2015; 53(3):
220-9.
Thank You
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