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- Gorreja, Frida, 1990-, et al.
(author)
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A survey on patients medication reconciliation process in an oncological hospital
- 2017
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In: Recenti Progressi in Medicina. - Rome, Italy : Il Pensiero Scientifico Editore. - 0034-1193. ; 108:3, s. 141-148
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Journal article (other academic/artistic)abstract
- Objectives. The purpose of this study was to assess the impact of medication reconciliation in the clinical practice from a hospital pharmacist point of view.Methods. A survey of the medication taken by cancer patients was performed on admission and on discharge in an Oncological hospital, and then the subjects were followed up until discharge for 8 weeks. The pharmacist entered the data collected into a computer based tool which, by using Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP criteria) and Micromedex™ interactions database, automatically produces a report indicating the possible inconsistencies. The report is to check all potentially inappropriate prescriptions (PIPs) correlated to the drugs assumption by the patient. The appropriateness of the medication was scored using a Medication Appropriateness Index (MAI index) which was used to reconcile the medication list accordingly.Results. Patients reconciled at admission were 98, while patients reconciled at discharge were 90, 8 patients dropped out due to death. After the intervention of the hospital pharmacist, the average value of MAI index showed a significant reduction (3,391 to 2,552 p=0.039) and the median number of drugs prescribed per patient was decreased (7 vs 6; p=0.8058).Conclusion. Our study demonstrated that the forms used in the reconciliation process, in particular the record card, is a promising method to increase the quality of the information related to drug use in clinical decisions. We think that medication reconciliation softwares should be widely used by health care professionals involved in the recording of drug history or prescription process.
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| 2. |
- Russi, Alberto, et al.
(author)
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Improving the management of high cost anticancer drugs in a health care system
- 2016
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In: Global and Regional Health Technology Assessment. - Milan, Italy : Wichtig Publishing. - 2284-2403. ; 3:3, s. 155-158
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Journal article (other academic/artistic)abstract
- As a consequence of the rise in cancer prevalence and in the cost of anticancer drugs, global spending for cancer is increasing rapidly. The aim of this work is to identify and assess some effective cost management parameters and possible strategies to contain expenditure. Cost limitation could be achieved by implementing effective prevention measures and other main actions: diffusion of tailored therapies; systematic postmarketing reviews; cost-effectiveness assessment; accurate treatment choices; more transparent and effective managed entry agreement policies; waste management through personalized dose preparation. To better manage high cost anticancer drugs, oncologists and hospital pharmacists should collaborate in choosing the right drug, for the right patient, at the right time. In addition, besides promoting the use of biosimilars and generic drugs, when different products have a similar clinical effectiveness, a cost-minimization analysis should be performed to identify the best clinical approach at the lowest cost. With the same purpose, verifying real life outcomes by managing postmarketing analyses helps to renegotiate price agreements in a value-for-money model; this could be arranged if the regulatory agencies renegotiate the previously established price within a defined time period. Finally, the centralization of high-cost drug preparation and the implementation of a drug-day (vial sharing) will reduce drug waste.
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