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Impact of an innovative blood factor stewardship program on drug expense and patient care.
Amerine, Lindsey B; Chen, Sheh-Li; Daniels, Rowell; Key, Nigel; Eckel, Stephen F; Savage, Scott W.
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  • Amerine LB; Lindsey B. Amerine, Pharm.D., M.S., BCPS, is Assistant Director of Pharmacy, University of North Carolina (UNC) Medical Center, and Assistant Professor of Clinical Education, UNC Eshelman School of Pharmacy, Chapel Hill. Sheh-Li Chen, Pharm.D., BCOP, is Clinical Specialist, Hematology/Oncology, UNC
  • Chen SL; Lindsey B. Amerine, Pharm.D., M.S., BCPS, is Assistant Director of Pharmacy, University of North Carolina (UNC) Medical Center, and Assistant Professor of Clinical Education, UNC Eshelman School of Pharmacy, Chapel Hill. Sheh-Li Chen, Pharm.D., BCOP, is Clinical Specialist, Hematology/Oncology, UNC
  • Daniels R; Lindsey B. Amerine, Pharm.D., M.S., BCPS, is Assistant Director of Pharmacy, University of North Carolina (UNC) Medical Center, and Assistant Professor of Clinical Education, UNC Eshelman School of Pharmacy, Chapel Hill. Sheh-Li Chen, Pharm.D., BCOP, is Clinical Specialist, Hematology/Oncology, UNC
  • Key N; Lindsey B. Amerine, Pharm.D., M.S., BCPS, is Assistant Director of Pharmacy, University of North Carolina (UNC) Medical Center, and Assistant Professor of Clinical Education, UNC Eshelman School of Pharmacy, Chapel Hill. Sheh-Li Chen, Pharm.D., BCOP, is Clinical Specialist, Hematology/Oncology, UNC
  • Eckel SF; Lindsey B. Amerine, Pharm.D., M.S., BCPS, is Assistant Director of Pharmacy, University of North Carolina (UNC) Medical Center, and Assistant Professor of Clinical Education, UNC Eshelman School of Pharmacy, Chapel Hill. Sheh-Li Chen, Pharm.D., BCOP, is Clinical Specialist, Hematology/Oncology, UNC
  • Savage SW; Lindsey B. Amerine, Pharm.D., M.S., BCPS, is Assistant Director of Pharmacy, University of North Carolina (UNC) Medical Center, and Assistant Professor of Clinical Education, UNC Eshelman School of Pharmacy, Chapel Hill. Sheh-Li Chen, Pharm.D., BCOP, is Clinical Specialist, Hematology/Oncology, UNC
Am J Health Syst Pharm ; 72(18): 1579-84, 2015 Sep 15.
Article en En | MEDLINE | ID: mdl-26346214
PURPOSE: An innovative pharmacist-led program to improve prescribing, dosing, and monitoring of clotting factor therapy within a large health system is described. SUMMARY: In an initiative to optimize patient outcomes and control costs associated with the use of clotting factor concentrates, the pharmacy department at University of North Carolina Medical Center (UNCMC) led the development of a "factor stewardship program" in collaboration with UNCMC hematologists. Key steps in program development and implementation included (1) selection of one formulary product within each clotting factor class, (2) establishment of guidelines on blood factor prescribing, order review, compounding, and administration, and (3) initial and ongoing education of pharmacy, nursing, and medical staff. As part of the program, a designated pharmacist rounds with hematologists daily, recommending treatment plan modifications and dosage adjustments as appropriate. Now in its fifth year, the stewardship program has enabled consistent pharmacist oversight of all aspects of clotting factor use and enhanced transitions-of-care coordination. Through optimization of product selection, dosing regimens, and infusion frequencies, the number of blood factor doses in fiscal year 2013 was reduced by 45% from the prior year despite a 22% increase in the volume of treated patients; in patients with hemophilia A, re-admissions due to bleeding episodes have declined. During the four-year period ending in July 2014, estimated cost savings attributable to the stewardship program exceeded $4 million annually. CONCLUSION: Implementation of the UNCMC stewardship program has led to improved outcomes in patients receiving clotting factor concentrates, with significant institutional cost savings.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Factor VIIa / Costos de los Medicamentos / Mejoramiento de la Calidad / Atención al Paciente Tipo de estudio: Guideline / Health_economic_evaluation Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Am J Health Syst Pharm Asunto de la revista: FARMACIA / HOSPITAIS Año: 2015 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Factor VIIa / Costos de los Medicamentos / Mejoramiento de la Calidad / Atención al Paciente Tipo de estudio: Guideline / Health_economic_evaluation Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Am J Health Syst Pharm Asunto de la revista: FARMACIA / HOSPITAIS Año: 2015 Tipo del documento: Article Pais de publicación: Reino Unido