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Schönenberger N, Meyer-Massetti C, Bravo S. Development of a quality assessment tool for pharmacy and therapeutics committees and subsequent pilot testing. Eur J Hosp Pharm 2024; 31:171-174. [PMID: 36241377 PMCID: PMC10895181 DOI: 10.1136/ejhpharm-2022-003365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022] Open
Abstract
Pharmacy and therapeutics committees (PTCs) are multidisciplinary hospital teams responsible for rational medication use. We aimed at developing and piloting an assessment tool for their operating quality.We conducted a scoping literature review in PubMed and Embase to identify potential assessment items. Their relevance was systematically rated and consolidated into the final tool.60 relevant items were included, grouped into eight focus topics: the committee's institutional integration, member characteristics, performance indicators, meeting structure, formulary decision-making and characteristics, strategies to guide medication use and medication use evaluations.In combination with a SWOT (strengths, weaknesses, opportunities and threats) analysis, the tool helped the identification of improvement opportunities for a pilot hospital: adapting the committee's structure, improving the formulary decision-making, implementing strategies to guide formulary medication use and strengthening the committee's recognition within the institution.The tool successfully identified improvement opportunities for a PTC and could therefore be interesting for other hospitals.
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Affiliation(s)
- Nicole Schönenberger
- Department of General Internal Medicine, Clinical Pharmacology and Toxicology, University Hospital of Bern - Inselspital Bern, Bern, Switzerland
| | - Carla Meyer-Massetti
- Department of General Internal Medicine, Clinical Pharmacology and Toxicology, University Hospital of Bern - Inselspital Bern, Bern, Switzerland
- Institute for Primary Healthcare BIHAM, University of Bern, Bern, Switzerland
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2
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Hydery T, Reddy V. A primer on formulary structures and strategies. J Manag Care Spec Pharm 2024; 30:206-210. [PMID: 38308624 PMCID: PMC10838136 DOI: 10.18553/jmcp.2024.30.2.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2024]
Abstract
Formularies are a tool for managing costs, optimizing patient access, and improving overall health outcomes. The general goal of formularies is to provide access to appropriate therapy while promoting effective resource utilization, which allows the managed care pharmacy organization to operate sustainably. Traditional formulary strategies have included open and closed formularies as well as tiered formularies. However, other formulary structures have emerged in support of the focus on product value. The formulary development process is primarily driven by the pharmacy and therapeutics (P&T) committee and value committee within an organization. Key considerations such as member population, regional differences, regulatory/compliance implications, and benefit design strategies may influence payers to create a customized formulary to provide additional value to their members while managing costs. With the rise of high-cost and specialty products, formularies continue to serve as an important tool for managed care pharmacy organizations. Ongoing trends, such as biosimilars, prescription digital therapeutics, and addressing health equity, will shape future strategy and management of formularies.
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Holst SS, Møller CH, Vermehren C, Trolle S, Hansen B, Kirkedal ABK, Christensen HR, Jacobsen T, Mathiasen R, Andersen JÞT, Gade C. Establishment of a children's Drugs and Therapeutics Committee to ensure evidence-based and cost-effective medical treatment for children. Br J Clin Pharmacol 2024; 90:378-387. [PMID: 37879905 DOI: 10.1111/bcp.15944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/01/2023] [Accepted: 10/06/2023] [Indexed: 10/27/2023] Open
Abstract
The prevalence of undocumented medical treatments among children is a significant issue, as well as many EU countries lack access to newly developed children-friendly medicines. Consequently, there is a pressing need for supplementary resources that can facilitate informed decision-making regarding children's medication. We therefore aim to describe the process of establishing a children's Drug and Therapeutics Committee (cDTC), as well as the preparing and implementation of recommendations for children in the capital region of Denmark. Following the guidelines outlined by the World Health Organization, we established a cDTC, and recommendations for paediatric medication practice were constructed from assessments of medication use patterns among children in the capital region between 2019 and 2021. The recommendations were meticulously crafted based on evaluation of the current marketing authorization landscape and existing best available evidence. In 2019, the capital region established the first cDTC supported by expert councils and an editorial board. A total of 2429 purchase item numbers covering 1 222 846 defined daily doses and 592 088 purchased packages covering 10 200 000 defined daily doses were identified in the secondary and primary sectors, respectively. Three comprehensive lists covering recommendations for newborns and children were published between 2021 and 2020 totaling 331 recommended pharmaceutical products. The recommendations primarily intended for use in the secondary healthcare sector were implemented through the revision of 38 paediatric- and six neonatal product ranges throughout capital region. In conclusion, recommendation lists for children governed by a cDTC provide a rational auxiliary tool that can be immediately implemented in the clinic.
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Affiliation(s)
- Sara Sommer Holst
- Department of Clinical Pharmacology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Camilla Holten Møller
- Department of Clinical Pharmacology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Charlotte Vermehren
- Department of Clinical Pharmacology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
| | - Stine Trolle
- The Hospital Pharmacy, Copenhagen University Hospital, Copenhagen, Capital Region of Denmark, Denmark
| | - Bente Hansen
- Department of Pediatrics and Adolescents Medicine, Copenhagen University Hospital Northern Zealand, Copenhagen, Denmark
| | - Ann-Britt Kiholm Kirkedal
- Department of Pediatrics and Adolescents Medicine, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark
| | - Hanne Rolighed Christensen
- Department of Clinical Pharmacology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Thorkild Jacobsen
- Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - René Mathiasen
- Department of Children and Adolescents Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Jón Þór Traerup Andersen
- Department of Clinical Pharmacology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christina Gade
- Department of Clinical Pharmacology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Kimbowa IM, Ocan M, Mukonzo J, Nakafeero M, Eriksen J, Stålsby Lundborg C, Ogwal-Okeng J, Obua C, Kalyango J. The role of medicines and therapeutics committees structure in supporting optimal antibacterial use in hospitals in Uganda: A mixed method study. PLoS One 2024; 19:e0289851. [PMID: 38241225 PMCID: PMC10798471 DOI: 10.1371/journal.pone.0289851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/21/2023] [Indexed: 01/21/2024] Open
Abstract
Although the roles of Medicines and therapeutic committees (MTCs) have been expanding, there is limited information on the role of their structure in optimal antibacterial use in hospitals, especially in low-and-middle-income countries. Our study explored the structure and role of MTC in supporting antibacterial use in regional referral, general hospitals and tertiary private not-for-profit (PNFP) hospitals in Uganda. We conducted an explanatory sequential mixed-method approach with triangulation to explore the structure and functional role of MTCs from August 2019 to February 2020 in hospitals in Uganda. Quantitative data was collected using an interviewer-administered questionnaire among chairpersons or secretaries of MTCs and was analysed using descriptive statistics. We conducted key informant interviews using an interview guide among long-term serving members of MTCs to collect qualitative data which triangulated the quantitative data. The study revealed that sixteen hospitals had successfully established MTCs with an average duration of the MTCs' existence of 5.6 (+2.7) years. The membership of the MTCs varied between 7 and 14, with a median value of 10, and the majority of members in MTCs were pharmacists (15 out of 16) and clinical specialists (13 out of 16). The most frequent subcommittees of the 16 hospitals MTC were supply chain (n = 14), antimicrobial stewardship (n = 13), and infection control (n = 12). Majority (14 out of 16) of the MTCs supported availability and access of antibacterial use by selecting and evaluating antibacterials agents for their formulary lists using established criteria. Additionally, 15 out 16 MTCs conducted antimicrobial stewardship activities to support optimal antimicrobial use. In our study, MTC membership and subcommittees were critical structural components that aided the selection and evaluation antibacterials on hospital formulary lists and they supported optimal antibacterial use through implementing various antimicrobial stewardship activities. There is a need for the Ministry of Health to conduct more training on operationalising MTCs structures in all hospitals.
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Affiliation(s)
- Isaac Magulu Kimbowa
- Department of Pharmacology and Therapeutics, Makerere University College of Health Sciences, Kampala, Uganda
| | - Moses Ocan
- Department of Pharmacology and Therapeutics, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jackson Mukonzo
- Department of Pharmacology and Therapeutics, Makerere University College of Health Sciences, Kampala, Uganda
| | - Mary Nakafeero
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jaran Eriksen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Celestino Obua
- Office of the Vice Chancellor, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joan Kalyango
- Department of Pharmacy, Makerere University College of Health Sciences, Kampala, Uganda
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5
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Wild D. ASHP Pharmacy Technician Forum Executive Committee. Am J Health Syst Pharm 2022; 79:1222-1223. [PMID: 35760557 DOI: 10.1093/ajhp/zxac173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wild D. ASHP Pharmacy Technician Forum Executive Committee. Am J Health Syst Pharm 2022; 79:930-931. [PMID: 35466997 DOI: 10.1093/ajhp/zxac114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Borja-Hart NL, Rowe AS, Gatwood J, Wheeler J. Incorporation of a mock pharmacy and therapeutics committee as an entrustable professional activity supporting task. Curr Pharm Teach Learn 2021; 13:784-788. [PMID: 34074508 DOI: 10.1016/j.cptl.2021.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/12/2020] [Accepted: 03/25/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Entrustable professional activities (EPAs) denote activities and tasks students should be able to perform by graduation irrespective of their practice setting. Formulary decision-making includes several core EPA related skills, such as utilization of drug information, written, and verbal skills. The objective of this study was to describe an EPA supporting task aimed at improving utilization of evidence-based medicine skills and its impact on student self-perceived confidence, rating of skills needed, and competence. METHODS Teams comprised of six to seven students were assigned a drug and instructed to complete the following activities: (1) background literature search, (2) drug monograph, (3) five-min presentation to simulate a live pharmacy and therapeutics (P&T) committee meeting, and (4) vote on a formulary drug in each drug class. Students completed a pre/post five-point Likert scale self-efficacy survey and a perceived importance survey. A scoring rubric assessed monograph and presentation elements (max points 30). Survey items were analyzed using Wilcoxon signed-rank test. Descriptive statistics were used for assignment grades. RESULTS One hundred ninety students completed the pre/post self-efficacy and perceived importance survey. Confidence showed statistically significant improvement (P < .001) in nine target skill areas. In ranking importance, all 12 assessed skills exhibited a statistically significant increase following the activity. CONCLUSIONS A mock P&T activity represents an innovative way to evaluate an EPA supporting task that allows students to improve their evidence-based analysis, written, and verbal communication skills.
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Affiliation(s)
- Nancy L Borja-Hart
- University of Tennessee Health Science Center College of Pharmacy, Department of Clinical Pharmacy and Translational Science, 301 S. Perimeter Park Dr., Suite 220, Nashville, TN 37211, United States.
| | - A Shaun Rowe
- University of Tennessee Health Science Center College of Pharmacy, Department of Clinical Pharmacy and Translational Science, 1924 Alcoa Highway, Box 117, Knoxville, TN 37920, United States.
| | - Justin Gatwood
- University of Tennessee Health Science Center College of Pharmacy, Department of Clinical Pharmacy and Translational Science, 301 S. Perimeter Park Dr., Suite 220, Nashville, TN 37211, United States.
| | - James Wheeler
- University of Tennessee Health Science Center College of Pharmacy, Department of Clinical Pharmacy and Translational Science, 1924 Alcoa Highway, Box 117, Knoxville, TN 37920, United States.
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González-Morcillo G, Calderón-Hernanz B, Rodríguez-Camacho JM. Cost-effectiveness of drug therapy prescribed in special situations at hospital. Farm Hosp 2020; 44:272-278. [PMID: 33156745 DOI: 10.7399/fh.11451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Abstract
OBJECTIVE The Pharmacy and Therapeutics Committee is an advisory body to the medical management of our hospital. Following Royal Decree 86/2015, which regulates the Pharmacy and Therapeutics Committee of the Balearic Islands, this committee prepared a technical report in which it assessed the possible internal use of off-label drugs, drugs for compassionate use, and drugs not included in the hospital's pharmacotherapeutic guide. The objective was to analyse the clinical response achieved with the use of these drugs and their associated costs. METHOD Retrospective study of drugs whose use was requested from the hospital's Pharmacy and Therapeutics Committee hospital between January and December 2018. We analysed whether the requested treatment achieved the objective established by the physician. The cost was calculated based on the duration of the treatment until the objective was achieved or until treatment was discontinued. RESULTS In total, 70 requests were analysed: 59% achieved the expected therapeutic goal, 34% were considered to be therapeutic failures, and 7% were lost to follow-up. The overall cost of the 70 authorized treatments was €1,140,240. The average cost per request was €16,288. Oncology and Haematology services submitted more than 50% of the requests, and more than 75% of the budget was allocated to these medical services. CONCLUSIONS More than half of the treatments analysed by the Pharmacy and Therapeutics Committee of the hospital achieved their therapeutic goal, although the economic cost of their use was high.
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Affiliation(s)
| | - Beatriz Calderón-Hernanz
- Servicio de Farmacia, Hospital Universitario Son Llàtzer, Palma de Mallorca. Spain.Hospital Universitario Son Llàtzer.
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Moore GD, Burns AL, Fish H, Gandhi N, Kebodeaux C, Meny LM, Policastri A, Sneed KB, Traynor A, Vosooney A, Bradley-Baker LR. The Report of the 2019-2020 Professional Affairs Standing Committee: Pharmacist Integration with Primary Care Practices. Am J Pharm Educ 2020; 84:ajpe8199. [PMID: 33149338 PMCID: PMC7596612 DOI: 10.5688/ajpe8199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The 2019-2020 Professional Affairs Committee was charged to (1) Describe the leadership role of schools of pharmacy in advancing interprofessional practice, with an emphasis on physician-pharmacist collaborative relationships; (2) Establish an inventory of resources that can support school efforts to grow collaborative partnerships between pharmacists and physicians; (3) Determine gaps that exist in the resources required to support schools in efforts to facilitate expansion of interprofessional partnerships; and (4) Define strategies and draft an action plan for AACP's role in facilitating member school efforts to accelerate the development of interprofessional practices within their geography of influence. This report provides information on the committee's process to address the committee charges as well as background and resources pertaining to the charges, describes the rationale for and the results from the focus groups conducted at the 2020 AACP Interim Meeting, communicates the results of an initial inventory of models that integrate pharmacists with primary care practices, and provides an overview on issues to continue the work to integrate pharmacists with primary care practices. The committee offered several revisions to current association policy statements and provided a proposed policy statement and several recommendations to AACP pertaining to the committee charges.
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Affiliation(s)
- Gina D Moore
- University of Colorado, Skaggs School of Pharmacy & Pharmaceutical Sciences, Aurora, Colorado
| | - Anne L Burns
- American Pharmacists Association, Washington, District of Columbia
| | - Hannah Fish
- National Community Pharmacists Association, Alexandria, Virginia
| | - Nidhi Gandhi
- American Association of Colleges of Pharmacy, Arlington, Virginia
| | - Clark Kebodeaux
- University of Kentucky, College of Pharmacy, Lexington, Kentucky
| | - Lisa M Meny
- Ferris State University, College of Pharmacy, Grand Rapids, Michigan
| | - Anne Policastri
- American Society of Health-System Pharmacists, Bethesda, Maryland
| | - Kevin B Sneed
- University of South Florida, College of Pharmacy, Tampa, Florida
| | - Andy Traynor
- Concordia University of Wisconsin, School of Pharmacy, Mequon, Wisconsin
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10
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Welch BE, Arif SA, Bloom TJ, Isaacs AN, Janke KK, Johnson JL, Moseley LE, Ross LJ. Report of the 2019-2020 AACP Student Affairs Standing Committee. Am J Pharm Educ 2020; 84:ajpe8198. [PMID: 33149337 PMCID: PMC7596594 DOI: 10.5688/ajpe8198] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The 2019-2020 Student Affairs Standing Committee addressed charges related to professional identity formation (PIF) in order to set direction and propose action steps consistent with Priority #3.4 of the AACP Strategic Plan, which states "Academic-practice partnerships and pharmacist-involved practice models that lead to the progress of Interprofessional Practice (IPP) are evident and promoted at all colleges and schools of pharmacy." To this end, the committee was charged to 1) outline key elements of PIF, 2) explore the relationship between formal curricular learning activities and co- or extra-curricular activities in supporting PIF, 3) determine the degree to which there is evidence that strong PIF is embedded in student pharmacists' educational experience, and 4) define strategies and draft an action plan for AACP's role in advancing efforts of schools to establish strong PIF in pharmacy graduates. This report describes work of the committee in exploring PIF and provides resources and background information relative to the charges. The committee offers several suggestions and recommendations for both immediate and long-term action by AACP and members to achieve goals related to integrating PIF into pharmacy education. The committee proposes a policy statement relative to the committee charges. Furthermore, the report calls upon the profession to develop a unified identity and incorporate support for PIF into pharmacy education, training, and practice.
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Affiliation(s)
- Beth E Welch
- Western New England University, College of Pharmacy and Health Sciences, Springfield, Massachusetts
| | - Sally A Arif
- Midwestern University, Chicago College of Pharmacy, Downers Grove, Illinois
| | - Timothy J Bloom
- Shenandoah University Bernard J. Dunn School of Pharmacy, Winchester, Virginia
| | - Alex N Isaacs
- Purdue University College of Pharmacy, West Lafayette, Indiana
| | - Kristin K Janke
- University of Minnesota College of Pharmacy, Minneapolis, Minnesota
| | | | | | - Libby J Ross
- American Association of Colleges of Pharmacy, Arlington, Virginia
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Chair ASB, Crabtree B, Franson K, Klepser D, Okere AN, Poirier T, Welch A, Gandhi N, Ragucci K. Report of the 2019-2020 AACP Academic Affairs Committee: Developing the Pharmacist Workforce for Society's Medication Use Needs in 2030. Am J Pharm Educ 2020; 84:ajpe8203. [PMID: 33149340 PMCID: PMC7596602 DOI: 10.5688/ajpe8203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The 2019-2020 Academic Affairs Committee was charged with identifying promising practices in academic-practice partnerships and professional pharmacy organization initiatives that are accelerating the transformation of a workforce prepared to assume responsibility for society's medication use needs in 2030 and determining the role AACP can plan in supporting these partnerships and initiatives. The committee identified a set of ideal principles, characteristics, and design elements of a high-quality, large-scale workforce development program. The committee also categorized current mechanisms for professional workforce development, in addition to identifying their strengths and weaknesses, with the realization that novel approaches are needed to accomplish the goal of large-scale workforce transformation. This report also highlights two existing initiatives aligned with accelerating the transformation of the workforce (ie, the Community Pharmacy Enhanced Services Network (CPESN) ACT (Academia-CPESN Transformation) Pharmacy Collaborative and the American Pharmacists Association ADVANCE platform) and is proposing a policy statement affirming AACP's support. Furthermore, the committee is proposing another policy statement supporting colleges and schools of pharmacy taking an active role in implementing innovative and novel approaches for the development of the current workforce. In order to truly understand the many factors influencing large-scale workforce transformation, the committee is also proposing a stakeholder conference with a wide range of participants and a targeted set of questions focused on current and future needs.
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Affiliation(s)
| | - Brian Crabtree
- Mercer University, College of Pharmacy, Atlanta, Georgia
| | - Kari Franson
- University of Southern California, College of Pharmacy, Los Angeles, California
| | - Donald Klepser
- University of Nebraska Medical Center, College of Pharmacy, Omaha, Nebraska
| | | | - Therese Poirier
- Southern Illinois University, Edwardsville School of Pharmacy, Edwardsville, Illinois
| | - Adam Welch
- East Tennessee State University, Bill Gatton College of Pharmacy, Johnson City, Tennessee
| | - Nidhi Gandhi
- American Association of Colleges of Pharmacy, Arlington, Virginia
| | - Kelly Ragucci
- American Association of Colleges of Pharmacy, Arlington, Virginia
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Chair PAC, Allen DD, Boyle CJ, DiPiro JT, Scott SA, Maine LL. Advancing Our Pharmacy Reformation - Accelerating Education and Practice Transformation: Report of the 2019-2020 Argus Commission. Am J Pharm Educ 2020; 84:ajpe8205. [PMID: 33149341 PMCID: PMC7596599 DOI: 10.5688/ajpe8205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
The Argus Commission examined changes that should be considered by colleges and schools of pharmacy to meet the bold aim of better integrating pharmacists' and physicians' practices articulated by President Sorensen. The Commission assessed the readiness of pharmacy educators to contribute to the acceleration of practice transformation. The primary focus of the report is on how the doctor of pharmacy curriculum and post-graduate training might be modified and better aligned to ensure that graduates complete their education ready to engage in roles partnered with primary care clinicians. The aim is to achieve comprehensive medication management and other pharmacist patient care services as standards of care. The Argus Commission provides preliminary recommendations for new or more intensified priorities by the 2020-21 AACP Strategic Planning Committee as they update the AACP plan. This includes the recommendation that AACP should create the Center for Academic Innovation and Practice Transformation, a hub to coordinate many current and emerging activities relevant to accelerating change in pharmacy education and practice.
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Affiliation(s)
- Patricia A Chase Chair
- Oregon State University/Oregon Health Sciences University College of Pharmacy, Portland, Oregon
| | - David D Allen
- University of Mississippi, School of Pharmacy, University, Mississippi
| | - Cynthia J Boyle
- University of Maryland, School of Pharmacy, Baltimore, Maryland
| | - Joseph T DiPiro
- Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia
| | - Steven A Scott
- Purdue University, College of Pharmacy, West Lafayette, Indiana
| | - Lucinda L Maine
- American Association of Colleges of Pharmacy, Arlington, Virginia
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Chair GK, Bacci JL, Chui MA, Farley J, Gannett PM, Holstad SG, Livet M, Farrell D. Implementation Science to Advance Practice and Curricular Transformation: Report of the 2019-2020 AACP Research and Graduate Affairs Committee. Am J Pharm Educ 2020; 84:ajpe848204. [PMID: 33149346 PMCID: PMC7596610 DOI: 10.5688/ajpe848204] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The 2019-2020 AACP Research and Graduate Affairs Committee (RGAC) was charged with articulating the case for and evaluating the state of implementation science in academic pharmacy, given the potential for implementation science to act as a driver of practice and curricular transformation. Based on the current state of pharmacy research in this area, the RGAC was further charged with outlining a plan to raise the profile of implementation science with pharmacy leadership and defining strategies for AACP to facilitate schools in applying its methods to their practice and education missions. For this work, the RGAC considered implementation science to be the scientific study of methods and strategies to promote adoption of evidence-based practices and interventions into real world settings and routine practice, to improve the quality and effectiveness of services. The RGAC identified three components of an effective strategy for AACP to assist schools in applying implementation science in practice and education: 1) raising awareness of implementation science as an opportunity for academic pharmacy, 2) connecting pharmacy researchers with the larger implementation science community, and 3) developing pharmacy researchers in the competencies and methods associated with implementation science. Specific recommendations for this strategy were informed by searches of the literature and funding landscape related to implementation science and pharmacy. The RGAC also identified stakeholder groups that AACP could target in a campaign to raise awareness of implementation science and connectivity to the existing research community in this space, including academic leadership, faculty with expertise in relevant research methodologies (eg, the Social and Administrative Science (SAS) section of AACP), and the academic pharmacy community as a whole.
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Affiliation(s)
- Grace Kuo Chair
- Oregon State University College of Pharmacy, Corvallis, Oregon
| | - Jennifer L Bacci
- University of Washington School of Pharmacy, Seattle, Washington
| | - Michelle A Chui
- University of Wisconsin-Madison School of Pharmacy, Madison, Wisconsin
| | - Joel Farley
- University of Minnesota College of Pharmacy, Minneapolis, Minnesota
| | - Peter M Gannett
- Nova Southeastern University College of Pharmacy, Fort Lauderdale, Florida
| | | | - Melanie Livet
- University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, North Carolina
| | - Dorothy Farrell
- American Association of Colleges of Pharmacy, Arlington, Virginia
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Ross LA, Sease J, Zillich A, Downing DF, Turner K, Shrader S, Crichlow R, Snead B, Cárdenas J. Report of the 2019-2020 Strategic Engagement Standing Committee. Am J Pharm Educ 2020; 84:ajpe8202. [PMID: 33149339 PMCID: PMC7596608 DOI: 10.5688/ajpe8202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
For the American Association of Colleges of Pharmacy (AACP) strategic engagement is critical to the success of colleges and schools of pharmacy in expanding pharmacy and public health practice, meeting programmatic needs, and fulfilling institutional missions. The 2019-2020 Strategic Engagement Committee was charged with exploring the collaborative relationships colleges and schools have within their state to advance pharmacy practice. More specifically, this committee was tasked to examine those relationships with current state pharmacy and medical associations. This report seeks to provide insights from this work and share recommendations to assist AACP in facilitating practice transformation. To uncover current schools' relationships with state and medical associations, the committee utilized AACP's ability in convening members to conduct focus groups at INsight 2020 and one-on-one interviews with key faculty members. Overall, partnerships with state pharmacy associations are successful or growing, whereas there is still work to be done in developing relationships and collaborating with medical and health care societies. We found that there are several schools with "best practices" related to state association collaborations and look to highlight exemplar practices in this report as they are critical towards practice transformations.
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Affiliation(s)
- Leigh Ann Ross
- University of Mississippi, School of Pharmacy, University, Mississippi
| | - Julie Sease
- University of South Carolina, College of Pharmacy, Columbia, South Carolina
| | - Alan Zillich
- Purdue University, College of Pharmacy, Lafayette, Indiana
| | - Donald F Downing
- University of Washington, School of Pharmacy, Seattle, Washington
| | - Kyle Turner
- University of Utah, College of Pharmacy, Salt Lake City, Utah
| | - Sarah Shrader
- University of Kansas, School of Pharmacy, Lawrence, Kansas
| | - Renee Crichlow
- University of Minnesota Medical School, Minneapolis, Minnesota
| | - Becky Snead
- National Alliance of State Pharmacy Associations, North Chesterfield, Virginia
| | - Jasey Cárdenas
- American Association of Colleges of Pharmacy, Arlington, Virginia
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Khadka S, Saeed H, Shahi J, Bajgain Y, Yadav TP, Gupta RP. Utilizing Hospital Formulary System in Nepal. J Nepal Health Res Counc 2020; 18:337-339. [PMID: 32969408 DOI: 10.33314/jnhrc.v18i2.2647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
Since the early 1950s, for medication management, the hospital formulary system subsisted as a list of drugs into the supply chain management process in hospitals. With the advent of pharmacy practice services, the system now is more oriented towards the rational use of drugs taking into account the safety of therapy, cost-effectiveness, and uninterrupted availability of drugs to improve and reflect upon the clinical judgment of healthcare professionals. Though very few hospitals in Nepal have adopted hospital formulary system, the perfect practice is still skimpy. The formation of drug and therapeutic committee along with the establishment of hospital pharmacy services is a growing trend with the arrival of hospital pharmacy guidelines 2072, thus, a positive spill-over of the hospital formulary system to each hospital in Nepal would be valuable in promoting rational drug therapy. Keywords: Cost-effectiveness; hospital formulary system, rational drug therapy.
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Affiliation(s)
- Sitaram Khadka
- Shree Birendra Hospital, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Hamid Saeed
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Janak Shahi
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Yogesh Bajgain
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Tank Prasad Yadav
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Ravi Prasad Gupta
- Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
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Affiliation(s)
- Jared P Austin
- Department of Pediatrics, Oregon Health & Science University, Portland
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17
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McLaughlin MM, Short E, Prusi R, Masic D, Chapman NR, Postelnick M. Implementation of a pharmacy research committee to enhance the pharmacy resident research experience. Curr Pharm Teach Learn 2017; 9:1141-1146. [PMID: 29233383 DOI: 10.1016/j.cptl.2017.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 05/03/2017] [Accepted: 07/28/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND PURPOSE Most postgraduate year 1 (PGY1) pharmacy residents complete at least one research project as part of their graduation requirements. The research skills learned prepare residents to address research questions and generate evidence-based recommendations for patient care. However, there are multiple steps involved in a research project, and streamlining this process can be difficult. EDUCATIONAL ACTIVITY AND SETTING Northwestern Memorial Hospital (NMH), a large academic center located in Chicago, IL, developed a research committee (RC) to facilitate research within the department of pharmacy for residents and to maintain residency research support materials. These materials included a charter to help guide the organizational structure and operations of the RC, research timelines, and a seminar series. FINDINGS The RC works to ensure that the residents overcome any challenges that they may incur during their research projects by setting clear expectations and milestones. Feedback is provided by the residents and incorporated into the research process and support materials. DISCUSSION The RC allows for individualized attention and personalization of the research experience for each resident. The program endeavors each year to provide the message that publication should be the final goal of a research project and not presentation at a conference. SUMMARY Pharmacy residents receive support from the RC from throughout the year, not only when issues surround their project arise. Institutions may implement or modify existing programs based upon the resources provided.
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Affiliation(s)
- Milena M McLaughlin
- Department of Pharmacy Practice, Midwestern University, Chicago College of Pharmacy, 555 31st Street, Downers Grove, IL, United States; Northwestern Memorial Hospital, Department of Pharmacy, 251 E Huron Street, Chicago, IL, United States.
| | - Elizabeth Short
- Northwestern Memorial Hospital, Department of Pharmacy, 251 E Huron Street, Chicago, IL, United States.
| | - Rachael Prusi
- Northwestern Memorial Hospital, Department of Pharmacy, 251 E Huron Street, Chicago, IL, United States.
| | - Dalila Masic
- Department of Pharmacy Practice, Midwestern University, Chicago College of Pharmacy, 555 31st Street, Downers Grove, IL, United States.
| | - Noelle Rm Chapman
- Northwestern Memorial Hospital, Department of Pharmacy, 251 E Huron Street, Chicago, IL, United States.
| | - Michael Postelnick
- Northwestern Memorial Hospital, Department of Pharmacy, 251 E Huron Street, Chicago, IL, United States.
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Eriksen J, Gustafsson LL, Ateva K, Bastholm-Rahmner P, Ovesjö ML, Jirlow M, Juhasz-Haverinen M, Lärfars G, Malmström RE, Wettermark B, Andersén-Karlsson E. High adherence to the 'Wise List' treatment recommendations in Stockholm: a 15-year retrospective review of a multifaceted approach promoting rational use of medicines. BMJ Open 2017; 7:e014345. [PMID: 28465306 PMCID: PMC5775463 DOI: 10.1136/bmjopen-2016-014345] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES To present the 'Wise List' (a formulary of essential medicines for primary and specialised care in Stockholm Healthcare Region) and assess adherence to the recommendations over a 15-year period. DESIGN Retrospective analysis of all prescription data in the Stockholm Healthcare Region between 2000 and 2015 in relation to the Wise List recommendations during the same time period. SETTING All outpatient care in the Stockholm Healthcare Region. PARTICIPANTS All prescribers in the Stockholm Healthcare Region. MAIN OUTCOME MEASURES The number of core and complementary substances included in the Wise List, the adherence to recommendations by Anatomic Therapeutic Chemical (ATC) 1st level using defined daily doses (DDDs) adjusted to the DDD for 2015, adherence to recommendations over time measured by dispensed prescriptions yearly between 2002 and 2015. RESULTS The number of recommended core substances was stable (175-212). Overall adherence to the recommendations for core medicines for all prescribers increased from 75% to 84% (2000 to 2015). The adherence to recommendations in primary care for core medicines increased from 80% to 90% (2005 to 2015) with decreasing range in practice variation (32% to 13%). Hospital prescriber adherence to core medicine recommendations was stable but increased for the combination core and complementary medicines from 77% to 88% (2007 to 2015). Adherence varied between the 4 therapeutic areas studied. CONCLUSIONS High and increasing adherence to the Wise List recommendations was seen for all prescriber categories. The transparent process for developing recommendations involving respected experts and clinicians using strict criteria for handling potential conflicts of interests, feedback to prescribers, continuous medical education and financial incentives are possible contributing factors. High-quality evidence-based recommendations to prescribers, such as the Wise List, disseminated through a multifaceted approach, will become increasingly important and should be developed further to include recommendations and introduction protocols for new expensive medicines.
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Affiliation(s)
- Jaran Eriksen
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
| | - Lars L Gustafsson
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
| | - Kristina Ateva
- Stockholm Drug and Therapeutics Committee, Public Healthcare Services Committee, Stockholm, Sweden
| | - Pia Bastholm-Rahmner
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Marie-Louise Ovesjö
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Quality and Development, Södersjukhuset, Stockholm, Sweden
| | - Malena Jirlow
- Public Healthcare Services Committee, Stockholm, Sweden
| | | | - Gerd Lärfars
- Department of Clinical Science and Education, Södersjukhuset, Internal Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Rickard E Malmström
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Björn Wettermark
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eva Andersén-Karlsson
- Department of Clinical Science and Education, Södersjukhuset, Internal Medicine, Karolinska Institutet, Stockholm, Sweden
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Poindessous JL, Basta M, Michel-Dhaine C. [Not Available]. Rev Infirm 2017; 66:47-48. [PMID: 28366263 DOI: 10.1016/j.revinf.2017.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Jean-Luc Poindessous
- Service de rééducation et réadaptation neurologique, Hôpital de Meulan-Les Mureaux, 1 rue Baptiste-Marcet, 78130 Les Mureaux, France.
| | - Martial Basta
- Service de rééducation et réadaptation neurologique, Hôpital de Meulan-Les Mureaux, 1 rue Baptiste-Marcet, 78130 Les Mureaux, France
| | - Céline Michel-Dhaine
- Unité douleur, Hôpital de Meulan-Les Mureaux, 1 rue Baptiste-Marcet, 78130 Les Mureaux, France
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21
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Arnold DJ, Wax MK. Pediatric Microvascular Reconstruction: A Report from the Microvascular Committee. Otolaryngol Head Neck Surg 2016; 136:848-51. [PMID: 17478228 DOI: 10.1016/j.otohns.2006.11.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2006] [Accepted: 11/10/2006] [Indexed: 11/21/2022]
Abstract
BACKGROUND: Free tissue transfer is an integral part of modern head and neck surgery in the adult population. Its use in the pediatric population has not been well described. Recently, there has been an increase in the application of these techniques in the pediatric population. The morbidity of free tissue transfer in small pediatric patients and its effect on growth has not been well described. OBJECTIVE: To evaluate the utility of microvascular reconstruction techniques in the pediatric population. STUDY DESIGN: A consensus study was performed by the microvascular committee of the American Academy of Otolaryngology-Head and Neck Surgery. Thirty active microvascular surgeons reviewed their databases to find patients less than 21 years of age who underwent free tissue transfer. RESULTS: 49 free tissue transfers performed between 1999 and 2005. The mean age was 12.1 years (age range, 3–21). The types of flaps transferred were radial forearm (10), fibula (21), rectus abdominus (7), scapula (1), latissimus dorsi (3), groin (1), gracillus (4), and jejunum (2). Morbidity at the donor site was relatively minimal. Five patients developed wound breakdown. One of these required return to the operating room. Morbidity at the reconstructed site was also rare. Patients were followed for an average of 49 months (range, 1–131 months), and no problems were noted with growth at the donor or recipient sites. CONCLUSIONS: Free flaps in the pediatric population have morbidity and survival similar to those in the adult population. SIGNIFICANCE: While indications differ from those in the adult population, these techniques are viable and valuable and should be considered in the pediatric reconstructive paradigm.
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Affiliation(s)
- David J Arnold
- Department of Otolaryngology--Head and Neck Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
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22
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Jones R. DAKOTACARE's integrated medical and pharmacy management: enhancing value. S D Med 2014; 67:209. [PMID: 24851471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Santana RS, Jesus EMSD, Santos DGD, Lyra Júnior DPD, Leite SN, Silva WBD. [Indicators for drug selection in health systems: an integrative review]. Rev Panam Salud Publica 2014; 35:228-234. [PMID: 24793871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 01/11/2014] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE To produce a panel of the main drug selection indicators by performing an integrative literature review. METHODS After the elaboration of a review protocol, searches were conducted in LILACS, MEDLINE, Embase, and SciELO databases. The following search terms were used: "indicators"; "criteria"; "drug selection"; "pharmacy and therapeutics committee"; and "medication form"; with the applicable variations in English and Spanish. Sixteen original articles published between January 1996 and March 2012 were retrieved and reviewed to compose a panel of indicators. RESULTS Forty-five quantitative and qualitative indicators were identified. These indicators were grouped according to conceptual similarities in three categories: 1) assessment of pharmacy and therapeutics committee structure; 2) evaluation of the general processes of drug selection; and 3) evaluation of the results of drug selection. CONCLUSIONS The indicators identified reveal relative uniformity in the established patterns for drug selection. The group of indicators established in this study should serve as reference for the development and consolidation of drug selection in public health services.
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Affiliation(s)
| | | | | | | | - Silvana Nair Leite
- Departamento de Farmácia, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
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Karas A, Kuehl B. Leveraging hospital formularies for improved prescribing. Healthc Manage Forum 2014; 27:S17-S27. [PMID: 25046967 DOI: 10.1016/j.hcmf.2014.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Hospital formularies, guided by the Pharmacy and Therapeutics Committee, exist to optimize medication use by identifying and designating drugs of choice to guide rational prescribing, ultimately reducing patient risk and costs and improving patient outcomes. Guidelines and a framework exist to guide critical evaluations of medications for formulary listing; however, there may be opportunities to improve and standardize how a formulary change could be instituted in Canadian hospitals. A formulary change at an Ontario hospital revealed that there are some key challenges to the formulary change process including the importance of a robust project plan, appropriate resources, healthcare staff education, and acceptance.
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Deutsche Vereinigung zur Bekämpfung der Viruskrankheiten e.V. [Updated procedural rules of the Committee of virus Disinfection of the German Association for the Control of Virus Diseases e.V. (DVV) for certification of disinfectants]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55:1542-4. [PMID: 23114454 DOI: 10.1007/s00103-012-1568-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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González-Bueno J, Chamorro-de-Vega E, Alfaro-Lara ER, Galván-Banqueri M, Santos-Ramos B. Assessment of new drugs in a tertiary hospital using a standardized tool. Farm Hosp 2013; 37:388-393. [PMID: 24128101 DOI: 10.7399/fh.2013.37.5.763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
OBJECTIVE To describe the profile of new drugs evaluated by the Pharmacy and Therapeutics committee in a tertiary hospital using a standardized tool, the Guideline for the Introduction of New Drugs in the Formulary (GINF form), as main objective. MATERIALS AND METHODS Retrospective observational study of drugs was assessed during 2008-2011. Variables related to the drug, the request, and the result of the evaluation were collected based on information contained in the GINF form and in the assessment reports. RESULTS 63 of 75 assessed drugs (84%) were included in the hospital formulary. Only one drug (1%) was included without any restrictions. The rest of them were included as therapeutic equivalents (23%) or under specific recommendations (61%). Half of the drugs (6) not included had insufficient evidence of effectiveness compared with current treatments. Haematology and Medical Oncology were found to be the most active medical services in the application process. There was a high prevalence of drugs that had more than one advanced clinical trial (phase III and/or phase IV). Furthermore, 28% of assessed drugs were associated with a financial burden of more than ?10,000 per year for our hospital. Highquality information was provided by applicants to the P&T committee for drugs that were finally included. However, the relationship between the information provided to the P&T committee and its decision was not statistical significance. CONCLUSION The requests received were primarily related to drugs intended for parenteral use and most of them were antineoplastic drugs. The medical departments most heavily represented were Haematology and Oncology.
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Lee YY, Hsiao P, Lin YM, Yen YH, Chen HY. Successful implementation of a P&T-approved therapeutic interchange program of angiotensin II receptor blockers in a medical center in Taiwan. Value Health 2012; 15:S111-S115. [PMID: 22265056 DOI: 10.1016/j.jval.2011.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Therapeutic interchange is not a common practice in the medical society in Asia. We used clinic blood pressure readings, patients' tolerance, and cost saving as measures to evaluate the impact of a therapeutic interchange program implemented at a medical center in Taiwan. METHODS Taipei Medical University-Wan Fang Hospital initiated a therapeutic interchange program involving angiotensin II receptor blockers (ARBs). Data were retrospectively collected for 444 outpatients who were converted from other ARBs to candesartan. Evaluation of therapeutic efficacy, adverse effects associated with therapy, and drug costs was conducted before and after the program implementation. RESULTS Patients whose treatment was converted to candesartan experienced no statistically significant differences in blood pressure, and the average number of antihypertensive agents used per patient remained unchanged. A direct cost savings of US$62,237 was estimated for the 444 patients studied. Only 3.15% of the patients developed adverse drug reactions potentially related to candesartan, and none required hospitalization. CONCLUSIONS Based on the results of this retrospective chart review, the present ARB therapeutic interchange program was successfully developed and implemented. This is the first study to establish the positive impact of a well-run ARB therapeutic interchange program in Taiwan.
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Affiliation(s)
- Yen-Ying Lee
- Department of Pharmacy, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan
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Abstract
Gordon Schiff and colleagues present a new tool and checklist to help formularies make decisions about drug inclusion and to guide rational drug use.
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Affiliation(s)
- Gordon D Schiff
- Brigham and Woman's Hospital, Harvard Medical School, Boston, MA, USA.
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Rahmner PB, Lundborg M. [The responsibility for medications list should be clear. Swedish Drug Committees (LOK) has published guidelines]. Lakartidningen 2011; 108:1250-1252. [PMID: 21786501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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30
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Stichele RV. The 'wise list'- a comprehensive model for drug and therapeutics committees to achieve adherence to recommendations for essential drugs among prescribers? Basic Clin Pharmacol Toxicol 2011; 108:221-3. [PMID: 21414142 DOI: 10.1111/j.1742-7843.2011.00684.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Helgeland D. Stimulant utilization in treating attention-deficit/hyperactivity disorder in South Dakota's Medicaid population. S D Med 2010; 63:383-384. [PMID: 21117519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Furängen A, Anders C. [What do the Swedish Drug and Therapeutics Committees think about cost savings?]. Lakartidningen 2010; 107:1790; author reply 1790. [PMID: 20812570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Griffiths M. Medicines management. Nurs Stand 2010; 24:28. [PMID: 20572552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Furängen A, Cronlund A. [What should embrace a national therapeutic drug strategy?]. Lakartidningen 2010; 107:1486-1487. [PMID: 20645603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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How expert opinion influences P&T decisions. Manag Care 2010; 19:52. [PMID: 20524369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Weizman AV, Griesman J, Bell CM. The use of research abstracts in formulary decision making by the Joint Oncology Drug Review of Canada. Appl Health Econ Health Policy 2010; 8:387-391. [PMID: 21043540 DOI: 10.2165/11530510-000000000-00000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND AND OBJECTIVE Opinions on the use of research abstracts in policy decision making are conflicting. We sought to evaluate the influence of research abstracts in guiding decisions of the Joint Oncology Drug Review of Canada (JODR), which conducts clinical and economic reviews of new cancer treatment drugs for formulary listing. METHODS The minutes of the monthly meetings of the JODR between 2005 and 2007 were reviewed. One submission per drug indication was included. Elements evaluated included the level of evidence supporting each decision, the year the study was published and subsequent publication of any abstracts. RESULTS There were 73 recommendations reviewed over the 36 months. Ten recommendations were deferred and eight recommendations were re-submissions, thus 55 recommendations underwent analysis. There were 31 recommendations based to some extent on abstracts, of which 14 (45%) were in favour of formulary listing and 17 (55%) were opposed. Twelve recommendations were based exclusively on abstracts, seven (58%) of which were in favour of formulary listing. As a comparison, published randomized controlled trials were part of the evidentiary base in 30 committee recommendations (55%). Of these, 17 (57%) were in favour of formulary listing, while 13 (43%) were opposed. CONCLUSIONS Research abstracts are commonly involved in evidence-based decision making for formulary listing. The rates of approving cancer drugs for funding by the JODR were similar among recommendations based on abstracts and other levels of evidence. Abstracts can play an important role in guiding decision making.
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Affiliation(s)
- Adam V Weizman
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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[Position of the Drug Committee of German Physicians on vaccination against the new influenza A (H1N1)]. Kinderkrankenschwester 2009; 28:463-5. [PMID: 19953852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Asberg KH. [Drug committees' information leaflets are needed]. Lakartidningen 2009; 106:2384. [PMID: 19848349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Abstract
Meperidine is FDA-approved for relieving moderate to severe pain and has been widely used since its introduction in the 1930s. However, the drug is no longer considered a first-line analgesic. Many clinicians recommend that meperidine be removed from health-systems or that its use be restricted, due to concerns about adverse reactions, drug interactions, and normeperidine neurotoxicity. In addition, clinical evidence shows that meperidine has no advantage over other opioids for biliary colic or pancreatitis. The formulary status of meperidine has been extensively discussed at University of Utah Hospitals and Clinics. The Pharmacy and Therapeutics Committee has been working with hospital staff to assess the impact of either removing meperidine from the formulary, or limiting its use. The Drug Information Service developed this document to help pharmacists respond to prescribers' questions and to alleviate the prescribers' concerns about these changes. Information is provided comparing meperidine with other opioids, including dosage equivalency, pharmacodynamics, pharmacokinetics, cost, adverse effects, and drug interactions. Where available, alternatives to meperidine are suggested for various indications.
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Affiliation(s)
- M Christina Beckwith
- University Hospitals and Clinics, and College of Pharmacy, University of Utah, Salt Lake City 84132, USA.
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Boethius G. Recording of drug prescriptions in the County of Jämtland, Sweden. Pattern of drug usage in 16,600 individuals during 1970-75. Acta Med Scand 2009; 202:241-51. [PMID: 920241 DOI: 10.1111/j.0954-6820.1977.tb16821.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Jägestedt M, Ronge S, Wettermark B, Karlsson EA. [Rational drug prescription: a question of knowledge and direction. Qualitative study at ten community health centers in the county of Stockholm]. Lakartidningen 2008; 105:2924-2929. [PMID: 19025149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Armstrong K, Mitton C, Carleton B, Shoveller J. Drug formulary decision-making in two regional health authorities in British Columbia, Canada. Health Policy 2008; 88:308-16. [PMID: 18508151 DOI: 10.1016/j.healthpol.2008.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2007] [Revised: 04/13/2008] [Accepted: 04/14/2008] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Growing pharmaceutical demands challenge healthcare organizations to set drug funding priorities (i.e. establish a formulary list). This responsibility typically rests with pharmacy and therapeutics (P&T) committees, yet how the process transpires within regional health authorities is unclear. The purpose of this study was to construct an explanatory model of drug formulary priority-setting as it occurs within regional health authorities. METHODS A grounded theory approach was employed to study the practices of two regional health authority P&T committees in British Columbia, Canada. Data sources spanned committee documents, meeting observations (n=4), and semi-structured interviews with committee members (n=15). Data analysis involved coding using the constant comparative technique and writing analytic memos. RESULTS Regional P&T committees engaged in two activities related to drug formulary priority-setting: developing auto-substitution policies and reviewing drug addition requests. Four processes were central to decision-making: (i) negotiating margins of therapeutic advantage; (ii) seeking value for the resources allocated; (iii) interfacing between community and institutional settings; (iv) situating decisions within an organizational context. CONCLUSIONS Findings highlight opportunities for institutions to improve the fairness of agenda-setting practices, and for additional collaboration between policy-makers who prioritize drugs for publicly funded formularies applicable to institutional versus community settings.
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Affiliation(s)
- Kristy Armstrong
- Department of Health Care and Epidemiology, Faculty of Medicine, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC V6T 1Z3, Canada.
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García-Alonso MDC, García-Mariñoso B. The strategic interaction between firms and formulary committees: effects on the prices of new drugs. J Health Econ 2008; 27:377-404. [PMID: 18276026 DOI: 10.1016/j.jhealeco.2007.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2006] [Revised: 05/09/2007] [Accepted: 06/13/2007] [Indexed: 05/25/2023]
Abstract
We study the strategic interaction between the pricing decisions of a pharmaceutical firm and the reimbursement decisions of a government agency which grants reimbursement rights to patients for whom new drugs are most cost-effective. If the reimbursement decision precedes pricing, the agency only reimburses some patients if the drug's private and public health benefits diverge. This is, there are consumption externalities and the variable cost of the drug exceeds the alternative's. Contrarily, if the firm can commit to a price before reimbursement, a strategic effect implies that by setting a sufficiently high price, the firm can make the agency more willing to reimburse than without commitment.
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Björkman IK, Schmidt IK, Holmström I, Bernsten CB. Developing the role of the drug and therapeutics committees: perceptions of chairs. Int J Health Care Qual Assur 2008; 20:161-78. [PMID: 17585614 DOI: 10.1108/09526860710731843] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE According to Swedish law, every county is required to have a local drug and therapeutics committee (DTC) to contribute to safe and cost-effective drug use. The law presents merely a framework and gives no detailed instructions addressing, for example, organisation and methods. The aim of this study is to explore the variation of conceptions of the role of the DTCs among committee Chairs and to compare the results with an earlier study. DESIGN/METHODOLOGY/APPROACH Data were collected by questionnaires and telephone interviews with committee chairs, which were analysed using a phenomenographic approach. FINDINGS Four conceptions were identified, namely: traditional, patient-aware, influential, holistic and cooperative, which all involved prescribers. In one conception the DTC acted as an expert to decision-makers. One conception included the notion that cooperation across the bureaucratic borders was important. Patients were involved in two conceptions. Comparison with the earlier study showed a trend toward higher patient awareness and a higher agreement on DTC goals with an increased focus on quality issues. ORIGINALITY/VALUE This study demonstrates an alternative research method bringing in new perspectives when exploring activities within healthcare. Patient involvement in the work of the DTCs is increasing, but should be further explored and developed.
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Affiliation(s)
- Ingeborg K Björkman
- Department of Public Health and Caring Sciences, University of Uppsala, Uppsala, Sweden.
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Persson U, Ramsberg J. [Health economics evaluations are of great significance for Pharmaceutical Benefit Board's decisions]. Lakartidningen 2007; 104:3046-3050. [PMID: 17985712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- Ulf Persson
- Institutet för hälso- och sjukvårdsekonomi (IHE), Lund.
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Saad AH, Sweet BV, Stumpf JL, Gruppen L, Oh M, Stevenson JG. Pharmacist recognition of and adherence to medication-use policies and safety practices. Am J Health Syst Pharm 2007; 64:2050-4. [PMID: 17893416 DOI: 10.2146/ajhp070001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Pharmacist recognition of and adherence to medication-use policies and safety practices were assessed. METHODS Simulation testing was used to assess the performance of pharmacists in hypothetical scenarios simulating real-life situations. Fifty test case medication orders were developed, some requiring specific intervention and some requiring no special action. Orders were classified into four categories: those posing safety concerns n ( = 16), those with formulary and product standardization issues (n = 4), those with pharmacy and therapeutics (P&T) committee restrictions (n = 4), and those requiring no special action (n = 26). Potential barriers to compliance were identified by the project team and the orders categorized accordingly. The orders were processed by 25 pharmacists using a simulation testing procedure. Data were analyzed by pharmacists' demographics, order category, and perceived barriers to compliance. RESULTS Pharmacists were correctly able to recognize 77.3% of test orders: 67.3% with safety concerns, 98.9% with formulary issues, and 98.5% with restrictions. Appropriate action was taken with 74.2% of test orders: 64.5% of safety orders, 96.6% of formulary orders, and 92.4% of restriction orders. There was no correlation between pharmacists' performance and demographic characteristics. The two barriers to correct response identified most often were ambiguous responsibility and low perceived level of importance. CONCLUSION Pharmacists generally recognized and took appropriate action with simulated medication orders that contained problems related to formulary or P&T committee restrictions. They were less able to recognize and act appropriately on orders with safety-related problems. Ambiguous responsibility and low perceived importance were the most significant factors contributing to noncompliance with P&T committee policies and guidelines.
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Affiliation(s)
- Aline H Saad
- Department of Pharmacy Services, University of Michigan Hospitals and Health Centers (UMHHC), Ann Arbor, MI 48109-0008, USA.
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Williams K. Evolution of evidence-based medicine and implications for pharmacy & therapeutics committees. Manag Care Interface 2007; 20:6-7. [PMID: 18405201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Minkoff NB. Multiple vaccines: how do we choose? J Manag Care Pharm 2007; 13:S16-20. [PMID: 17955625 PMCID: PMC10437628 DOI: 10.18553/jmcp.2007.13.s7-b.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND As preventive medicine is a cornerstone of managed care, most health plans have traditionally featured automatic vaccine coverage routed through the medical benefit. However, with the advent of emerging vaccines, managed care stakeholders must revise decision-making processes and choose among multiple products targeting the same disease. OBJECTIVE To review the motivating forces behind traditional vaccine coverage in managed care and discuss the need for managed care organizations (MCOs) to subject their vaccine policies to greater examination in the changing landscape of emerging vaccines. SUMMARY While variable vaccine coverage or choices in vaccine coverage is a relatively novel concept in managed care, the evaluation of vaccines in this setting is usually most effectively performed via a traditional route for MCOs: the Pharmacy & Therapeutics (P&T) committee. In some cases, a technology assessment committee is a more appropriate avenue for evaluation, depending on the disease state, administration, and plan infrastructure. Through these routes of evaluation, criteria similar to those used for other pharmaceutical agents under review should be employed in the review of vaccine options. The primary criteria evaluated include safety, efficacy, cost, and value. In addition, a set of miscellaneous factors must also be considered, including both tangible and intangible components. For example, the relevance of an agent to the specific covered population, compliance costs offsets, quality-of-life considerations, and both patient and provider demand should all be taken into account. Human papillomavirus vaccination provides a pragmatic example for applying the aforementioned strategy for vaccine evaluation in managed care. CONCLUSION The changing landscape of vaccine coverage in managed care, particularly in the availability of novel agents, demonstrates a need for MCOs to subject their vaccine policies to much greater examination. Through traditional avenues such as P&T and technology assessment committees, stakeholders should seek to evaluate standard criteria such as safety, efficacy, and cost-effectiveness, with additional considerations made for factors unique to the preventive nature of vaccines.
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Freedman K, Kolluri B, Neudecker L. Antimicrobial stewardship stabilizes resistance patterns in a behavioral health setting. Conn Med 2007; 71:457-60. [PMID: 17902382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND Connecticut Valley Hospital, an inpatient tertiary care psychiatric hospital, identified a significant increase in the antimicrobial resistance of E. coli to multiple antibiotics including quinolones. OBJECTIVES To improve the resistance profile of E. coli by better managing the usage of quinolones at this hospital. METHODS Education was provided to physicians, nurses and pharmacists regarding antibiotic usage, restriction and prior approval of quinolones. Further education was provided when the program was determined to be effective, and continued for another year. RESULTS A significant reduction of the prescription of quinolones was demonstrated. The resistance patterns of E. coli to quinolones and other antibiotics stabilized. CONCLUSION In this psychiatric hospital inpatient population, antimicrobial stewardship proved to be an effective tool in managing antibiotic utilization and stabilizing antimicrobial resistance among E. coli isolates.
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Abstract
OBJECTIVES To evaluate existing information on questions of therapy coordination between primary and hospital care and to identify activities with positive results that could be adapted at the local level. DESIGN Systematic review. DATA SOURCES MEDLINE, SIETES, and Cochrane systematic review databases were searched for articles published between January 1990 and August 2005. SELECTION OF STUDIES Those conducted in countries with a National Health Service. Thirty-six studies were included: a) observational studies on drug prescription for patients moving between primary and specialist care (18 studies); b) studies of the views of health professionals: review and consensus articles and editorials (7 articles); qualitative studies (4 articles); c) intervention studies (7 studies). Four-hundred and thirty-one studies were excluded. RESULTS The most common problems were: lack of information for patient follow-up, disagreement in drug selection, increases in costs due to hospital stays and difficulties in assuming clinical responsibilities. The solution put forward was that a unified policy of common medicines and budgets is essential. Little information was available on the studies that posed or evaluated interventions to improve therapy coordination. Conditions with the most information available were heart failure, diabetes mellitus, asthma, high blood pressure, and anticoagulant treatment. CONCLUSIONS The creation of pharmacotherapy committees, involving professionals belonging to both primary and specialist care, was proposed. These committees would adapt for local use protocols and clinical practice guidelines, in line with the prescription quality standards of primary care.
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Affiliation(s)
- Eladio Fernández Liz
- Servei d'Atenció Primària Muntanya de Barcelona, Institut Català de la Salut, Barcelona, Spain.
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