Reviewing prescription spending and accessory usage

Abstract

This article aims to explore the role of the stoma nurse specialist in the community and how recent initiatives within the NHS have impacted on the roles in stoma care to react to the rising prescription costs in the specialty. The article will explore how the stoma care nurse conducted her prescription reviews within her own clinical commissioning group (CCG). The findings of the reviews will be highlighted by a small case history and a mini audit that reveals that some stoma patients may be using their stoma care accessories inappropriately, which may contribute to the rise in stoma prescription spending. To prevent the incorrect use of stoma appliances it may necessitate an annual review of ostomates (individuals who have a stoma), as the author's reviews revealed that inappropriate usage was particularly commonplace when a patient may have not been reviewed by a stoma care specialist for some considerable amount of time. Initial education of the ostomate and ongoing education of how stoma products work is essential to prevent the misuse of stoma appliances, particularly accessories, as the reviews revealed that often patients were not always aware of how their products worked in practice.

A proven pathway for stoma care: the value of stoma care services

“…This represented an 8% reduction of the total stoma care spend (£50 087) for that particular GP surgery. This small audit is supported by other recent audits that have been recently published, demonstrating the inappropriate use of accessories (Mangnall et al, 2013;Oxenham, 2014).…”

“…In addition, yearly follow-up, which incorporates prescription review, may ensure that stoma prescribing remains appropriate to a stoma patient's needs and this may in turn help keep stoma prescription spends down. Forging relationships with clinical commissioning groups (CCGs) and medicines managers is paramount to appropriate prescribing in stoma care being communicated and understood (Oxenham, 2014).…”

Prophylactic mesh use during primary stoma formation to prevent parastomal hernia

“…In situations such as PSH where there are difficulties managing the stoma, this can rise to £6,000. 44 None of the estimated costs incorporate the expense and/or time of dedicated stoma care nurses.…”

Value-Based Healthcare in Ostomies

“…The role of stoma care nurses, annual follow-ups, and initial and long-term education has developed, and is essential to prevent poor use of the devices and accessories. This can lead to reduced prescription costs, have a positive effect on patients' health-related quality of life (HRQL), and reduce issues associated with adverse events, healthcare resources, and healthcare costs [10][11][12][13]. Although there are several studies on the improvement in quality of life of ostomy patients, such as those cited above, none of them evaluate a new model of comprehensive patient management such as the one that has been implemented in our region.…”