The cost-saving effect and prevention of medication errors by clinical pharmacist intervention in a nephrology unit

Abstract

Medication errors may lead to adverse drug events (ADEs), which endangers patient safety and increases healthcare-related costs. The on-ward deployment of clinical pharmacists has been shown to reduce preventable ADEs, and save costs. The purpose of this study was to evaluate the ADEs prevention and cost-saving effects by clinical pharmacist deployment in a nephrology ward.This was a retrospective study, which compared the number of pharmacist interventions 1 year before and after a clinical pharmacist was deployed in a nephrology ward. The clinical pharmacist attended ward rounds, reviewed and revised all medication orders, and gave active recommendations of medication use. For intervention analysis, the numbers and types of the pharmacist's interventions in medication orders and the active recommendations were compared. For cost analysis, both estimated cost saving and avoidance were calculated and compared.The total numbers of pharmacist interventions in medication orders were 824 in 2012 (preintervention), and 1977 in 2013 (postintervention). The numbers of active recommendation were 40 in 2012, and 253 in 2013. The estimated cost savings in 2012 and 2013 were NT$52,072 and NT$144,138, respectively. The estimated cost avoidances of preventable ADEs in 2012 and 2013 were NT$3,383,700 and NT$7,342,200, respectively. The benefit/cost ratio increased from 4.29 to 9.36, and average admission days decreased by 2 days after the on-ward deployment of a clinical pharmacist.The number of pharmacist's interventions increased dramatically after her on-ward deployment. This service could reduce medication errors, preventable ADEs, and costs of both medications and potential ADEs.

Cost-Efficiency of Medication Safety Program at Public Hospital, Riyadh, Saudi Arabia

“…The general administration of pharmaceutical care underway pharmacy practice as part of pharmacy strategic plan in Saudi Arabia. The previously study by Chen C et al 14 The predictable cost saving was calculated conventionally by a 1 day cost of the intervened medications. Moreover, the estimated cost avoidance was also calculated orthodoxly based on only 2 extra days of admission if ADEs occurred, although this may have resulted in more than 2 days of admission according to the Chen C et al 11 Other study by Najafzadeh M et al found contrasted from our results.…”

“…However, Chen CC et al revealed that the benefit/cost ratio increased from 4.29 to 9.36 and average admission days decreased by 2 days after the on-ward deployment of a clinical pharmacist. 14 In addition, the total cost avoidance was 103,073,160 -224,590,140 US $ annually. Another study by Najafzadeh M et al found 52% reduced of medication reconciliation discrepancies and total saved was 175,306 US $ in the study period.…”

Patient misadventures caused by prescribing errors detected at a Brazilian community pharmacy

“…Several studies have associated prescription errors with extra expenses accrued for institutions or health systems. 5,7,16 In view of the method used in this study, and the hesitation of some participants to report the amount of money spent, it was impossible to quantify their financial loss. However, based on the report of 19 (59.4%) participants, it was demonstrated that prescribing errors are also source for unnecessary expenditure because the medicines were not dispensed.…”

“…5,6 Studying medication errors and their causes has been an important tool to identify opportunities for the improvement of the medication process, with a consequent reduction in the risks and costs associated with these adverse events. 7 However, this information has evidently not been sufficient to convince health managers and prescribers to invest in changes that can reduce prescribing errors. Therefore, although prescribing errors have been widely studied, misadventures experienced by patients due these errors are neglected by healthcare professionals, especially in the cases of low-income patients covered by public health systems.…”

“…Therefore, although prescribing errors have been widely studied, misadventures experienced by patients due these errors are neglected by healthcare professionals, especially in the cases of low-income patients covered by public health systems. 7,[8][9][10] Notwithstanding the difficulty in demonstrating most relevant outcomes produced by prescription errors, some of these errors may be easily monitored and their results can be measured. A prescription error that makes it impossible to dispense a drug is a temporary obstacle for medication access.…”