Economic and safety benefits of pharmaceutical interventions by community and hospital pharmacists in Japan

Tasaka, Yuichi; Yasunaga, Daiki; Tanaka, Mamoru; Tanaka, Akihiro; Asakawa, Takashige; Horio, Ikuo; Miyauchi, Yoshiro; Araki, Hiroaki

doi:10.1007/s11096-015-0245-6

Cited by 27 publications

(19 citation statements)

References 19 publications

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“…This study was performed at 20 hospitals from April 2015 to March 2017 in Ehime Prefecture, Japan. Data on pharmaceutical interventions were stored in a web-based database that we previously developed using FileMaker Server 13 v3 [14]. After performing a pharmaceutical intervention, pharmacists spontaneously and anonymously uploaded the details of the intervention to the database, excluding the patient’s personal information (e.g., name, date of birth, and address).…”

Section: Methodsmentioning

confidence: 99%

“…Using an original evidence-based approach, we previously showed that pharmaceutical interventions at university hospitals in Japan may save up to USD 228,160 per year by preventing ADRs [13]. Furthermore, we developed a web-based database of pharmaceutical interventions, and illustrated the characteristics and problems of intervention by community and hospital pharmacists [14]. However, the underlying problems of the prescriptions requiring pharmaceutical interventions were not fully elucidated in our earlier study.…”

Section: Introductionmentioning

confidence: 99%

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Potential drug-related problems detected by routine pharmaceutical interventions: safety and economic contributions made by hospital pharmacists in Japan

Tasaka

Tanaka

Yasunaga

et al. 2018

J Pharm Health Care Sci

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BackgroundPharmaceutical intervention enables safe and effective pharmacotherapy by avoiding of adverse drug reactions (ADRs) and efficacy attenuations. Many prescriptions require optimization, and pharmaceutical interventions are inextricably associated with the prevention of potential drug-related problems (DRPs). Although the analysis and understanding of pharmaceutical interventions can lead to improvement in prescription, the analysis of routine pharmaceutical interventions in Japan in insufficient. Thus, we conducted this study to understand potential DRPs by analyzing routine pharmaceutical interventions made by pharmacists in Japan.MethodsPharmacists register the details of pharmaceutical interventions (excluding personal patient information) in a web-based database. We classified data of pharmaceutical interventions into 13 DRP types, 43 DRP subtypes, and 10 intervention categories (e.g., avoidance of serious ADRs and renal dosing recommendations). These data were analyzed with a focus on renal dysfunction and polypharmacy.ResultsDuring the study period, 2376 pharmaceutical interventions were performed. Overall, 68.2% of pharmaceutical interventions were for patients aged over 65 years. The most frequently detected potential DRP was overdosage, followed by omission of prescription, contraindications, and duplication of a drug with similar effect. The main cause of contraindication and overdosage was renal function deterioration, and that of polypharmacy was duplication of a drug with similar effect. Using our original evidence-based approach, we found that 2376 pharmaceutical interventions prevented ADRs for 1678 drugs, with potential cost savings of up to USD 2,657,820.ConclusionsOur results indicate that the analysis of routine pharmaceutical interventions is beneficial for detecting potential DRPs. Our findings also show that, in an aging society, pharmacists have an important role in providing medication safety, with potential cost savings.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Potential drug-related problems detected by routine pharmaceutical interventions: safety and economic contributions made by hospital pharmacists in Japan

Tasaka

Tanaka

Yasunaga

et al. 2018

J Pharm Health Care Sci

Self Cite

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“…Consequently, DRPs often lead to an increase in healthcare costs [3, 4]. In 2013, Tasaka et al [5] predicted a cost of more than 30 million dollars with DRPs in Japanese hospitals. Therefore, knowing the risks to which patients are exposed is of great importance to achieve safer drug therapy and, consequently, better disease management.…”

Section: Introductionmentioning

confidence: 99%

Drug related problems in the neonatal intensive care unit: incidence, characterization and clinical relevance

et al. 2019

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Background Any event involving drug therapy that may interfere in a patient’s desired clinical outcome is called a drug related problem (DRP). DRP are very common in intensive therapy, however, little is known about DRP in the Neonatal Intensive Care Unit (NICU). The purpose of this study was to determine the incidence of DRPs in NICU patients and to characterize DRPs according to type, cause and corresponding pharmaceutical conducts. Methods Prospective observational study conducted in the NICU at a teaching hospital in Brazil from January 2014 to November 2016. The data were collected from the records of the clinical pharmacy service, excluding neonates admitted for less than 24 h and those who had no drugs prescribed. DRPs were classified according to the Pharmaceutical Care Network Europe system and evaluated for relevance-safety. Results Six hundred neonates were included in the study, with mean gestational age of 31.9 ± 4.1 weeks and mean birth weight of 1779 ± 885 g. The incidence of DRPs in the NICU was 6.8% patient-days (95%CI 6.2–7.3%) and affected 59.8% of neonates (95% CI 55.8–63.8%). Sub-optimal effect (52.8%) and inappropriate dose selection (39.75%) were the most common problem and cause, respectively. Anti-infectives was the medication class most involved in DRPs. More than one-third of neonates were exposed to DRP of significant or high safety-relevance. Most of the pharmaceutical interventions were related with drug prescription, with over 90% acceptance by attending physicians. Conclusion DRP are common in NICU, predominating problems of sub-optimal treatment, mainly due to inappropriate dose selection. Electronic supplementary material The online version of this article (10.1186/s12887-019-1499-2) contains supplementary material, which is available to authorized users.

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“…In the United States, for example, the costs associated with adverse drug events (ADEs) doubled between 1995 and 2000, from US $76.6 billion to more than US $177.4 billion . The early identification of TRPs and preventable ADEs is a current area of focus for many health care systems that are in the pursuit of improving patient safety and reducing health care expenditures …”

Section: Introductionmentioning

confidence: 99%

Cost‐benefit analysis of clinical pharmacist intervention in preventing adverse drug events in the general chronic diseases outpatients

Alqudah

Al‐Badriyeh

Al‐Ali

et al. 2019

Evaluation Clinical Practice

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Rationale, aims, and objectives: Clinical pharmacy services are vital in the prevention of adverse drug events (ADEs) in clinical practice, extending beyond the hospital to chronic disease management in outpatient settings. This study sought to evaluate the cost benefit of a clinical pharmacy intervention in resolving treatment-related problems (TRPs) among hospital outpatients with chronic diseases.Methods: From the hospital system perspective, the cost-benefit analysis was based on a randomized clinical trial in the general outpatients of the major hospital in Jordan. Eligible patients were randomly assigned to either an intervention or a control group. TRPs were identified in both study groups, but interventions were delivered only to the intervention group via a home medication management review (HMMR) by a clinical pharmacist. A follow-up in both groups took place 3 months after recruitment. The total economic benefit was the sum of (a) cost savings due to intervention and (b) cost avoidance associated with preventable ADEs. The primary outcome measures were the net benefit and benefit-to-cost ratio with the clinical pharmacist-based HMMR. Results:In both groups, 158 TRPs were identified, and 79 interventions were provided in the study group. The monthly cost of intervention was JD764 (US $1078), and the total monthly benefit was JD4570 (US $6444), leading to a benefit-to-cost ratio of 5.98 and an annual net benefit of JD45 669 (US $64 393). Sensitivity analyses confirmed the robustness of results. Conclusion:The RCT-based cost-benefit evaluation provided evidence-based insight into the economic benefit of a clinical pharmacist-provided HMMR for preventing ADEs in the general chronic diseases outpatients. This intervention method against the TRPs among outpatients is cost beneficial and offers substantial cost savings to the health care hospital payer in Jordan.

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Economic and safety benefits of pharmaceutical interventions by community and hospital pharmacists in Japan

Cited by 27 publications

References 19 publications

Potential drug-related problems detected by routine pharmaceutical interventions: safety and economic contributions made by hospital pharmacists in Japan

Potential drug-related problems detected by routine pharmaceutical interventions: safety and economic contributions made by hospital pharmacists in Japan

Drug related problems in the neonatal intensive care unit: incidence, characterization and clinical relevance

Cost‐benefit analysis of clinical pharmacist intervention in preventing adverse drug events in the general chronic diseases outpatients

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