Pharmacists' admission medication histories (AMHs) are known to reduce adverse drug events (ADEs). Pharmacist-supervised pharmacy technicians (PSPTs) have also been used in this role. Nonetheless, few studies estimate the costs of utilizing PSPTs to obtain AMHs. We used time and motion methodology to study the time and cost required for pharmacists and PSPTs to obtain AMHs for patients at high risk for ADEs. Pharmacists and PSPTs required 58.5 (95% confidence interval [CI], 46.9-70.1) and 79.4 (95% CI, 59.1-99.8) minutes per patient, respectively (P = 0.14). PSPT-obtained AMHs also required 26.0 (95% CI, 14.9-37.1) minutes of pharmacist supervision per patient. Based on 2015 US Bureau of Labor Statistics wage data, we estimated the cost of having pharmacists and PSPTs obtain AMHs to be $55.91 (95% CI, 44.9-67.0) and $45.00 (95% CI, 29.7-60.4), respectively, which included pharmacist supervisory cost, per patient (P = 0.32). Thus, we found no statistically significant difference in time or cost between the two provider types.
Despite groundbreaking advances in health care, cardiovascular disease (CVD) remains the leading cause of death and disability worldwide, making it one of the most pressing global health issues to face the modern world. In 2002, Wald and Law proposed the concept of the polypill as a potential solution to this global health epidemic. The polypill represents a powerhouse pill that would consist of a combination of several key medications commonly prescribed for CVD prevention, such as a statin, diuretic, beta blocker, or angiotensin converting enzyme inhibitor, in one pill. It was suggested that it could be a novel, tactical measure in the approach to CVD prevention in that it greatly simplifies the healthcare delivery system. Not only does it increase medication compliance for those currently receiving health care, but it also has the potential to access those in underserved healthcare sectors of the world, primarily low- and middle-income countries, which have been identified as areas of highest CVD risk. A major drawback of the polypill is that there are limited data demonstrating its safety and efficacy in the prevention of cardiovascular morbidity and mortality. Thus far, research shows that the polypill has promise but needs to be approached with a few considerations, such as desired target patient population and formulation. This article will examine the published and ongoing studies associated with the polypill, outline the advantages and disadvantages of using the polypill as a global CVD prevention strategy, and discuss the design and availability of the polypill in the United States.
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