Cost–benefit and cost–savings analyses of antiarrhythmic medication monitoring

Abstract

Pharmacist monitoring of antiarrhythmic drug therapy in an out-patient clinic provided cost benefits, cost savings, and improved overall EP program efficiency.

Impact of a Pharmacy-Cardiology Collaborative Practice on Dofetilide Safety Monitoring

“…Measures such as management of drug-drug interactions, adjunctive medication optimization, and AAD adherence were not evaluated in our study. The intervention described in this study has the potential to improve access to care and decrease health care costs by reducing appointment burden for cardiology and primary care clinics 14 ; however, this was not specifically evaluated in our study. Of note, the time required for cardiologist staffing was not specifically timed per encounter but typically took 2 to 3 minutes per patient to review pertinent information with the pharmacist.…”

Pharmacist-Managed Inpatient Dofetilide Initiation Program: Description and Adherence Rate Post-Root Cause Analysis

“…8 -11 Utilizing pharmacists in antiarrhythmic management has been studied as well and been shown to increase adherence and safety while reducing cost of care. 12 -18 However, these studies often focused on outpatient antiarrhythmic management and evaluated one specific monitoring parameter as a primary outcome rather than reviewing their whole antiarrhythmic medication monitoring programs. 12 -18 In previous studies, electrolyte replenishment, patient adherence, or types of pharmacists’ intervention were studied as primary outcomes, but adherence to the institutional policy as a whole was not part of the assessment.…”

“…12 -18 However, these studies often focused on outpatient antiarrhythmic management and evaluated one specific monitoring parameter as a primary outcome rather than reviewing their whole antiarrhythmic medication monitoring programs. 12 -18 In previous studies, electrolyte replenishment, patient adherence, or types of pharmacists’ intervention were studied as primary outcomes, but adherence to the institutional policy as a whole was not part of the assessment. 12 -18 In addition, many included multiple antiarrhythmic medications in addition to dofetilide, mainly amiodarone.…”

“…12 -18 In previous studies, electrolyte replenishment, patient adherence, or types of pharmacists’ intervention were studied as primary outcomes, but adherence to the institutional policy as a whole was not part of the assessment. 12 -18 In addition, many included multiple antiarrhythmic medications in addition to dofetilide, mainly amiodarone. To our knowledge, there are only 4 reports of pharmacist-managed dofetilide initiation programs in the literature.…”

Practical messages from the EHRA consensus document on antiarrhythmic drug therapy

“…Unfortunately, both underlying diseases and comorbidities are dynamic. Therefore, not only a careful pre-administration assessment but also a follow-up for proarrhythmic effects is indicated ( 10 ). Appropriate laboratory and diagnostic tests should be part of the follow-up protocol; these tests should include ECG and other tests according to the patient’s profile and AAD characteristics.…”