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Pharmacist-Generated Medication Cost Avoidance in Palliative Care Clinical Settings (S546)
Abstract   Open access   Peer reviewed

Pharmacist-Generated Medication Cost Avoidance in Palliative Care Clinical Settings (S546)

Sarah Hannig, Lorin Fisher, Theodore Nguyen, James Ray and Kashelle Lockman
Journal of pain and symptom management, Vol.63(5), pp.931-931
05/2022
DOI: 10.1016/j.jpainsymman.2022.02.169
url
https://doi.org/10.1016/j.jpainsymman.2022.02.169View
Published (Version of record) Open Access

Abstract

1. Describe evidence on classifying and quantifying cost avoidance interventions by clinical pharmacists in critical care and emergency medicine 2. Identify palliative care clinical pharmacist interventions with and without cost avoidance estimations 3. Contrast estimated cost avoidance associated with palliative care clinical pharmacist interventions with those associated with critical care and emergency medicine pharmacist interventions Multiple studies have demonstrated favorable outcomes with pharmacist presence on palliative care (PC) teams, including decreased length of hospital stay and decreased time to goal attainment for symptom management. However, data on quantifying cost avoidance (CA) generated is limited. This study was performed to classify and quantify CA interventions by clinical pharmacy specialists in inpatient and outpatient palliative care at an academic medical center. All recommendations made by PC clinical pharmacists in a 1-month period were collected in a RedCap database. Accepted interventions were grouped into 6 pre-established categories from a validated systematic framework for pharmacist-generated CA interventions and evaluated with descriptive statistics. Five PC clinical pharmacists, representing 2 full-time equivalents, performed 433 interventions in 6 categories: adverse drug event (ADE) prevention (18.7%), resource utilization (24.2%), individualization of patient care (30.7%), prophylaxis (1%), hands-on care (23.8%), and administrative/supportive (1.8%). Overall, the most frequent interventions were initiation of therapy (29.5%) and deprescribing medications (24.2%). PC pharmacist-generated CA totaled $122,482, categorized accordingly: ADE prevention ($30,793; 25%), resource utilization ($7,028; 5.7%), individualization of patient care ($21,915; 17.9%), prophylaxis ($13,938; 11.4%), hands-on care ($51,356; 42%), and administrative/supportive ($882; 1%). Overall, the areas of greatest CA were medication teaching or discharge education ($28,167; 9.6%), bedside monitoring ($23,190; 14%), and initiation of therapy ($21,092; 30%). The average CA was $283 per intervention, $751 per patient, and $24,496 per pharmacist in the 4-week period. PC clinical pharmacists perform interventions that may reduce healthcare expenditures. Such activities demonstrate the value of a PC clinical pharmacist on a PC team and infer a potential benefit on patient care A large, multicenter study is needed to confirm results from this pilot study and to evaluate the impact of PC clinical pharmacist-generated CA interventions on patient-related outcomes.

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