Cost-avoidance and qualitative analysis of clinical pharmacy interventions by psychiatric pharmacy residents at state psychiatric facilities

Gardner, Kristen N.; Diefenderfer, Lauren A.; Nelson, Leigh Anne; Iuppa, Courtney A.; Elliott, Ellie; Kleinhesselink, Kalee; Sass, Debbie; Sommi, Roger W.

doi:10.2146/ajhp150368

Cited by 16 publications

(17 citation statements)

References 21 publications

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“…This suggests pharmacist interventions are well accepted by the health team. A similar rate was identified in the study by Gardner et al 22 , with 71% adherence to pharmacist interventions in psychiatric care and in a multicenter study conducted in France that found an acceptance rate for the intervention performed by pharmacists of 73% 23 .…”

Section: Discussionsupporting

confidence: 83%

Cost-benefit analysis of pharmacist interventions over 36 months in a university hospital

et al. 2020

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OBJECTIVE: To perform a cost-benefits analysis of a clinical pharmacy (CP) service implemented in a Neurology ward of a tertiary teaching hospital. METHODS: This is a cost-benefit analysis of a single arm, prospective cohort study performed at the adult Neurology Unit over 36 months, which has evaluated the results of a CP service from a hospital and Public Health System (PHS) perspective. The interventions were classified into 14 categories and the costs identified as direct medical costs. The results were analyzed by the total and marginal cost, the benefit-cost ratio (BCR) and the net benefit (NB). RESULTS: The total 334 patients were followed-up and the highest occurrence in 506 interventions was drug introduction (29.0%). The marginal cost for the hospital and avoided cost for PHS was US$182±32 and US$25,536±4,923 per year; and US$0.55 and US$76.4 per patient/year. The BCR and NB were 0.0, -US$26,105 (95%CI -31,850 – -10,610), -US$27,112 (95%CI -33,160–11,720) for the hospital and; 3.0 (95%CI 1.97–4.94), US$51,048 (95%CI 27,645–75,716) and, 4.6 (95%CI 2.24–10.05), US$91,496 (95%CI 34,700–168,050; p < 0.001) for the PHS, both considering adhered and total interventions, respectively. CONCLUSIONS: The CP service was not directly cost-benefit at the hospital perspective, but it presented savings for forecast cost related to the occurrence of preventable morbidities, measuring a good cost-benefit for the PHS.

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Section: Discussionsupporting

confidence: 83%

Cost-benefit analysis of pharmacist interventions over 36 months in a university hospital

et al. 2020

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“…17,18 The major strength of our impact study was to evaluate both cost savings and cost avoidance for each PI. Other pharmacist impact studies mostly focused on cost avoidance, for example in surgery, 9,13 psychiatry 19 or medical wards. 20,21 Surprisingly, there are few data on pharmacist impact in the oncology setting.…”

Section: Discussionmentioning

confidence: 99%

“…3 Clinical pharmacists activities evaluated in the study were not limited to one specific activity such as medication reconciliation or medication review like in major studies. 9,13,19,20 The authors performed PIs at any time between patient entry and his/her discharge but also outside the hospital as we did.…”

Section: Discussionmentioning

confidence: 99%

Clinical and economic impact of pharmacist interventions in an ambulatory hematology–oncology department

Grégori

Pistre

Boutet

et al. 2020

J Oncol Pharm Pract

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Objectives To evaluate clinical and financial impact of pharmacist interventions in an ambulatory adult hematology–oncology department. Methods All cancer patients receiving a first injectable immuno- and/or chemotherapy regimen were included in this prospective study over a one-year period. The clinical impact of pharmacist interventions made by two clinical pharmacists was rated using the Clinical Economic and Organizational tool. Financial impact was calculated through cost savings and cost avoidance. Main results: Five hundred and fifty-eight patients were included. A total of 1970 pharmacist interventions were performed corresponding to a mean number of 3.5 pharmacist interventions/patient. The clinical impact of pharmacist interventions was classified as negative, null, minor, moderate, major and lethal in 0, 84 (4%), 1353 (68%), 385 (20%), 148 (8%) and 0 cases, respectively. The overall cost savings were €175,563. One hundred and nine (6%) of all pharmacist interventions concerned immuno- or chemotherapy regimen for cost savings of €148,032 (84% of the total amount of cost savings). The cost avoidance was €390,480. Cost avoidance results were robust to sensitivity analyses with cost of preventable adverse drug event as main driver of the model. When the cost of employing a pharmacist was subtracted from the average yearly cost savings plus cost avoidance per pharmacist, this yielded a net benefit of €223,021. The cost–benefit ratio of the clinical pharmacist was €3.7 for every €1 invested. Principal conclusions: To have two full-time clinical pharmacists in a 55-bed ambulatory adult hematology–oncology department is both clinically and financially beneficial.

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“…From the literatures, the acceptance rate of clinical pharmacist ' s interventions within psychiatric team showed optimism among clinicians where it was equal or more than 70% from either clinical pharmacists or clinical pharmacy residents [11,12].…”

Section: Introductionmentioning

confidence: 99%

Implementation of clinical pharmacy service in a tertiary psychiatric hospital in Aseer region, Saudi Arabia: 15 month experience.

Sm¹,

Sm²,

Khobrani³

2019

biomedicalresearch

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Background: The provision of clinical pharmacy related services involves not only medication therapy, but decisions about medication selection, dosages, routes and methods of administration, medication therapy monitoring, and the provision of medication-related information and counselling to individual patients. Objective: To evaluate the clinical pharmacist's interventions with a focus on resolving drug related problems (DRPs). Methods: This is a prospective study that was performed in a tertiary mental health hospital in Abha city, Saudi Arabia. The clinical pharmacy team conducted a clinical rotation on a daily basis for rendering clinical pharmacy services. Based on the clinical pharmacist's assessment, the identified DRP's were identified and communicated with other clinicians to concerned patient-centered care and the resulting outcomes were measured. Also, the acceptance rate for the clinical pharmacist ' s interventions was evaluated. Results: A total of 824 DRPs were identified for 420 cases. The most common DRPs reported were found to be regarding Therapeutic Drug Monitoring (n=345, 41.87%) followed by need for counselling (n=175, 21.24%), drug selection (n=180, 21.84%), over or under dosage (n=87, 10.6%), adverse reactions (n=20, 2.43%), compliance (n=14, 1.7%), and under treatment (n=3, 0.36%). For all the identified DRP's a total of 446 interventions (54.13%) were proposed and accepted by the clinicians. Conclusion: Present study showed that introducing clinical pharmacist within the psychiatry team improves the therapeutic optimization and the clinical pharmacist is a trustworthy team member.

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Cost-avoidance and qualitative analysis of clinical pharmacy interventions by psychiatric pharmacy residents at state psychiatric facilities

Cited by 16 publications

References 21 publications

Cost-benefit analysis of pharmacist interventions over 36 months in a university hospital

Cost-benefit analysis of pharmacist interventions over 36 months in a university hospital

Clinical and economic impact of pharmacist interventions in an ambulatory hematology–oncology department

Implementation of clinical pharmacy service in a tertiary psychiatric hospital in Aseer region, Saudi Arabia: 15 month experience.

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