Systematic literature review of the methodology for developing pharmacotherapeutic interchange guidelines and their implementation in hospitals and ambulatory care settings

Adrover-Rigo, Maria; Fraga-Fuentes, Maria-Dolores; Puigventós-Latorre, Francesc; Martínez-López, Iciar

doi:10.1007/s00228-018-2573-7

Cited by 3 publications

(6 citation statements)

References 91 publications

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“…Therefore, solution strategies such as standardization through the use of switching algorithms and the involvement of pharmacists have already been investigated as recently reported [9][10][11]. However, the legal standardization of medication lists, e.g., through the Federal Medication List in Germany [12,13], should have significantly changed the framework conditions to obtain all relevant patient-and medication-related information for switching in recent times.…”

Section: Impact Of Findings On Practice Statementsmentioning

confidence: 99%

“…The switching algorithm was designed on the basis of the switching experience in the setting and international literature [9][10][11] by a panel of medical and pharmaceutical experts (consisting of the authors of this article). Combination products that were switched to mono-products (e.g., generics) were counted as generic switching.…”

Section: Switching Algorithmmentioning

confidence: 99%

“…Based on previous work, considering the heterogeneity of the admission departments and our experience with similar studies in the same setting [9][10][11], we assumed a patient number of at least 100 patients to be sufficient to draw conclusions in our setting and to find a pragmatic approach that can be realized in the time available.…”

Section: Study Sizementioning

confidence: 99%

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A newly developed algorithm for switching outpatient medications to medications listed in the hospital formulary: a prospective real-word evaluation in patients admitted electively to hospital

Möller,

Oetting,

Spiegel

et al. 2024

Eur J Clin Pharmacol

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Purpose In many countries, outpatient and inpatient care are separated. During hospitalization, therefore, switching the outpatient medication to medication of the hospital formulary is required. Methods We newly designed a switching algorithm in six switching steps (S0–S5) and conducted a study at Bundeswehr Hospital Hamburg (300 beds, 80% civilians). We performed (i) a medication reconciliation to obtain information on outpatient medications and (ii) a medication review to solve drug-related-problems, e.g., drug-drug interactions. We applied (iii) the algorithm to switch medications to the hospital formulary. Results (i) We identified 475 outpatient medications (median per patient: 4; Q25/Q75 2/7) in 100 patients consecutively admitted to hospital (median age: 71; Q25/Q75: 64/80 years). Of 475 medications, the switching algorithm could not be used since product names were missing in 23.9% and strength in 1.7%. In 3.2%, switching was not required since medication was not prescribed during the hospital stay. (ii) Drug-drug interactions were identified in 31 of 79 patients with more than one medication. (iii) Of 475 medications, 18.5% were on the hospital formulary and therefore did not need to be switched (S0), 0.2% were on a substitution-exclusion list not allowing switching (S1), 42.0% were switched to a generic medication of the hospital formulary (S2), 1.7% to a therapeutically equivalent medication (S3), 0.4% were patient-individually switched (S4), and for 8.2% a standardized/patient-individual switching was not possible (S5). Conclusions Despite comprehensive medication reconciliation, patient- and medication-related information for switching medications to the hospital formulary was often missing. Once all the necessary information was available, standardized switching could be easily carried out according to a newly developed switching algorithm.

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Section: Impact Of Findings On Practice Statementsmentioning

confidence: 99%

Section: Switching Algorithmmentioning

confidence: 99%

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A newly developed algorithm for switching outpatient medications to medications listed in the hospital formulary: a prospective real-word evaluation in patients admitted electively to hospital

Möller,

Oetting,

Spiegel

et al. 2024

Eur J Clin Pharmacol

View full text Add to dashboard Cite

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“…6 Therapeutic interchange occurs around the world in hospitals, general practices and community pharmacies. [7][8][9][10] Research suggests it can reduce healthcare system costs by using therapeutically equivalent but lowercost drugs. [11][12][13] In Australia, a hospital-based…”

Section: Introductionmentioning

confidence: 99%

“…Therapeutic interchange occurs around the world in hospitals, general practices and community pharmacies. 7–10 Research suggests it can reduce healthcare system costs by using therapeutically equivalent but lower-cost drugs. 11–13 In Australia, a hospital-based therapeutic equivalence programme had the dual benefit of saving the health service $A1 million per year and increasing junior doctors’ familiarity with the preferred drugs, potentially reducing prescribing errors.…”

Section: Introductionmentioning

confidence: 99%

Patient views of therapeutic interchange of ACE inhibitors in Australian primary care: a qualitative study

2021

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ObjectivesIn Australia, therapeutic interchange of angiotensin-converting enzyme (ACE) inhibitors could generate savings for patients and the Pharmaceutical Benefits Scheme (PBS). The PBS subsidises nine drugs in the ACE inhibitor class. These drugs are therapeutically equivalent, but the price varies between each drug. Patients are key players in successful therapeutic interchange programmes, but little is known about their views. This study aims to explore patient views of therapeutic interchange of ACE inhibitors in Australian primary care.DesignQualitative exploratory research study using semi-structured interviews, asking participants about therapeutic interchange and their attitude towards hypothetically switching ACE inhibitors. Data were analysed thematically.SettingAustralian primary care.ParticipantsFourteen adults in Australia currently taking an ACE inhibitor, recruited via general practices and pharmacies, social media and professional networks.FindingsFive key themes were identified: participants’ limited understanding of medication; the expectation that a new drug would be ‘the same’; the view that choice, convenience and fear of change outweigh the cost; altruism; and trust in health professionals, particularly participants’ own general practitioner (GP).ConclusionsPatients’ limited understanding of medication changes poses a barrier to therapeutic interchange. Clinicians should explore patients’ understanding and expectations of therapeutic interchange. Counselling from trusted health professionals, particularly GPs, could ameliorate concerns. Policymakers implementing therapeutic interchange programmes should ensure a trusted GP directs medication changes.

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Optimizing Use of Biologic Medicines Using a Quality Use of Medicines Approach

Weekes¹

2020

Biologics, Biosimilars, and Biobetters

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Systematic literature review of the methodology for developing pharmacotherapeutic interchange guidelines and their implementation in hospitals and ambulatory care settings

Cited by 3 publications

References 91 publications

A newly developed algorithm for switching outpatient medications to medications listed in the hospital formulary: a prospective real-word evaluation in patients admitted electively to hospital

A newly developed algorithm for switching outpatient medications to medications listed in the hospital formulary: a prospective real-word evaluation in patients admitted electively to hospital

Patient views of therapeutic interchange of ACE inhibitors in Australian primary care: a qualitative study

Optimizing Use of Biologic Medicines Using a Quality Use of Medicines Approach

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