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Bauer SR, Devlin JW. Costs and Resources Must Impact Clinical Decision-Making in the ICU: The Case of Vasopressor Use. Crit Care Med 2024:00003246-990000000-00356. [PMID: 38949473 DOI: 10.1097/ccm.0000000000006374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Affiliation(s)
- Seth R Bauer
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH
- Department of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
| | - John W Devlin
- Department of Pharmacy and Health Systems Sciences, Bouve College of Health Sciences, Northeastern University, Boston, MA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA
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Abu Esba LC, Almodaimegh H, Ahmed Khan M, Yousef CC, Al-Abdulkarim H, Al Aklabi AA, Al Harbi M. A Formulary Management Group Consensus. GLOBAL JOURNAL ON QUALITY AND SAFETY IN HEALTHCARE 2024; 7:88-94. [PMID: 38725883 PMCID: PMC11077514 DOI: 10.36401/jqsh-23-26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/20/2023] [Accepted: 01/04/2024] [Indexed: 05/12/2024]
Affiliation(s)
- Laila Carolina Abu Esba
- Pharmaceutical Care Department, King Abdulaziz Medical City, Ministry of National Guard, Health Affairs, Jeddah, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Hind Almodaimegh
- Pharmaceutical Care Department, King Abdulaziz Medical City, Ministry of National Guard, Health Affairs, Jeddah, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Mansoor Ahmed Khan
- King Abdullah International Medical Research Centre, Riyadh, Kingdom of Saudi Arabia
- Pharmaceutical Care Department, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Consuela Cheriece Yousef
- King Abdullah International Medical Research Centre, Riyadh, Kingdom of Saudi Arabia
- Pharmaceutical Care Department, Ministry of National Guard Health Affairs, Dammam, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Al Ahsa, Saudi Arabia
| | - Hana Al-Abdulkarim
- Doctoral School of Applied Informatics and Applied Mathematics, Óbuda University, Budapest, Hungary
- Drug Policy and Economic Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ali A. Al Aklabi
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Kingdom of Saudi Arabia
- Internal Medicine Division, Department of Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Mohammed Al Harbi
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Kingdom of Saudi Arabia
- Department of Anesthesia, King Abdulaziz Medical City, Ministry of National Guard, Riyadh, Saudi Arabia
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Aljuhani O, Al Sulaiman K, Bekairy AMA, Almajed K, Harbi MA, Thabit AK, Alharthi AF, Aldardeer N, Badreldin HA, Alhammad AM, Alenazi AO, Alghamdi B, Alsohimi S, Alshennawi M, Alshaya AI, Alrashed M, Al Shaya OA, Al-Jedai A. Clinical pharmacy services in acute care setting during mass gatherings (Hajj): Insights from a task force. J Infect Public Health 2024; 17 Suppl 1:68-75. [PMID: 37271687 DOI: 10.1016/j.jiph.2023.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Hajj is the largest mass gathering worldwide that takes place every year in Makkah, Saudi Arabia. This paper aims to provide a comprehensive guide and expectations for delivering and optimizing clinical pharmacy services during one of the largest mass gatherings in the world, Hajj pilgrimage METHODS: A task force initiated and included members of clinical pharmacists who previously participated in delivering clinical pharmacy services during the Hajj pilgrimage, members of the Saudi Society of Clinical Pharmacy (SSCP), and policymakers from different sectors and representatives from pharmaceutical care of the Ministry of Health (MOH). The members established an expert task force to conceptualize and draft the proposed suggestions highlighting the roles and responsibilities of clinical pharmacists during the annual Hajj season. RESULTS The task force determined the following key domains 1) pharmaceutical care (administration and strategic plan, resources, formulary management); 2) pharmacists' activities (clinical pharmacy services and documentation, professional training and development, and staff credentials, and qualifications); 3) challenges and proposed solutions. The task force was divided into groups to draft each domain and provide suggested statements and insights for each section. Finally, the group members of the task force issued 15 opinion statements. CONCLUSION Mass gatherings such as Hajj pilgrimage, represent a unique opportunity to demonstrate the value of pharmacists in advancing health care delivery within a multidisciplinary team. These suggestions and insights could guide the implementation of clinical pharmacy services in acute settings during mass gatherings (Hajj). Future studies should focus on assessing the applicability and the impact of the provided suggestions.
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Affiliation(s)
- Ohoud Aljuhani
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia; Saudi Critical Care Pharmacy Research Platform (SCAPE), Riyadh, Saudi Arabia
| | - Khalid Al Sulaiman
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs(,) Saudi Arabia; College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; Saudi Critical Care Pharmacy Research Platform (SCAPE), Riyadh, Saudi Arabia.
| | - Abdulkareem M Al Bekairy
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs(,) Saudi Arabia; College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Khalil Almajed
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs(,) Saudi Arabia; College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mahasen Al Harbi
- Pharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Abrar K Thabit
- Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Namareq Aldardeer
- Pharmaceutical Care Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Hisham A Badreldin
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs(,) Saudi Arabia; College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abdullah M Alhammad
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed O Alenazi
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs(,) Saudi Arabia; Pharmaceutical Care Department, King Abdulaziz Medical City, Dammam, Saudi Arabia
| | - Badr Alghamdi
- General Administration of Pharmaceutical Care, Ministry of Health, Riyadh, Saudi Arabia
| | - Samiah Alsohimi
- Pharmaceutical Care Services, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; Pharmaceutical Care Services, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Mohammed Alshennawi
- General Administration of Pharmaceutical Care, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdulrahman I Alshaya
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs(,) Saudi Arabia; College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mohammed Alrashed
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs(,) Saudi Arabia; College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Omar A Al Shaya
- King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs(,) Saudi Arabia; College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Ahmed Al-Jedai
- Therapeutic Affairs Deputyship, Ministry of Health, Riyadh, Saudi Arabia; Colleges of Medicine and Pharmacy, Al-Faisal University, Riyadh, Saudi Arabia
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Alkhudair N, Alhifany AA, Alsubaie B, Alshubaiki L, Alrajhi AM, alnuhait M. Assessing oncology providers attitudes and practices toward nonformulary drugs and mapping current obstacles in Saudi Arabia. Saudi Pharm J 2023; 31:101840. [PMID: 37961071 PMCID: PMC10638026 DOI: 10.1016/j.jsps.2023.101840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/19/2023] [Indexed: 11/15/2023] Open
Abstract
Introduction Formulary drug list is a continually updated list of medications routinely stocked by hospitals and other healthcare facilities and deemed effective, safe, and cost saving. Non-formulary drug (NFD) refers to medications not on the formulary, due to cost or lack of clinical data. This study aimed to examine the processing of NFD requests by oncology providers (OPs) in Saudi Arabia. Method A cross-sectional survey in Saudi oncology centers gathered perspectives of healthcare practitioners, mainly oncology pharmacists and physicians, on NFDs and request processes, aiming to understand variations, reasons for NFDs, and suggestions for an improved, unified NFDs request algorithm. Result A total of 93 physicians and pharmacists responded, 57 % were pharmacists, 43 % were physicians, and 94.6 % worked in the governmental sector. Around 31.2 % reported that it takes one week to receive a decision on their NFD request, while 28 % reported it takes two weeks to one month. Furthermore, 35.5 % of participants reported that the complete NFD process, from the initial order placement to the receipt of medications, spans a duration of 2-4 months, while 8.6 % noted a longer duration exceeding six months. The participants reported that the most common obstacles while requesting NFD were procurement delays and lengthy processing times. Additionally, 26.9 % agreed that formulary restrictions hindered medical care and 40.3 % reported delays in patient care. While 33.8 % were forced to use fewer effective options, and 22.1 % referred patients to palliative care. Conclusion The current practice of NFDs has negative consequences on cancer patient outcomes due to delays in patient care or the use of less effective drugs. Thus, we recommend having a national NFD access program.
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Affiliation(s)
- Nora Alkhudair
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah A. Alhifany
- Department of Pharmacy Practice, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Basha Alsubaie
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Leena Alshubaiki
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah M. Alrajhi
- Clinical Pharmacy Department, King Fahad Medical City, Riyadh, Saudi Arabia
- Department of Pharmacy Practice, College of Pharmacy, AlFaisal University, Riyadh, Saudi Arabia
| | - Mohammed alnuhait
- Department of Pharmacy Practice, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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Kuwana M, Tamura N, Yasuda S, Fujio K, Shoji A, Yamaguchi H, Iwasaki K, Makishima M, Kawata Y, Yamashita K, Igarashi A. Cost-effectiveness analyses of biologic and targeted synthetic disease-modifying anti-rheumatic diseases in patients with rheumatoid arthritis: Three approaches with a cohort simulation and real-world data. Mod Rheumatol 2023; 33:302-311. [PMID: 35445720 DOI: 10.1093/mr/roac038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/07/2022] [Accepted: 04/17/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the cost-effectiveness of biologic and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) in rheumatoid arthritis. METHODS We conducted three analyses: a lifetime analysis with a cohort model (Study A) and two short-term analyses (Studies B and C). Study A evaluated the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) gained from costs of standard treatments. Study B evaluated yearly costs per person achieving American College of Rheumatology (ACR) response (ACR20, ACR50, and ACR70), and Study C evaluated costs per person achieving previously defined claims-based effectiveness (equivalent to 28-joint Disease Activity Score ≤ 3.2). The proportion of ACR responders to the drugs of interest were determined by mixed treatment comparisons. Studies B and C estimated costs using a claims database. RESULTS In Study A, ICERs of all b/tsDMARDs were lower than 5.0 million Japanese yen (JPY) per QALY. In Study B, yearly costs per person with ACR50 response were lower for subcutaneous tocilizumab (TCZ-SC; 1.9 million JPY) and SC abatacept (2.3 million JPY). In Study C, costs per person were lower for TCZ-SC (1.3 million JPY) and intravenous TCZ (1.6 million JPY) and effectiveness rates were higher for intravenous TCZ (45.3%) and infliximab (43.0%). CONCLUSION The b/tsDMARDs with lower prices showed higher cost-effectiveness.
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Affiliation(s)
- Masataka Kuwana
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Bunkyo-ku, Tokyo 113-8602, Japan
| | - Naoto Tamura
- Department of Internal Medicine and Rheumatology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Shinsuke Yasuda
- Department of Rheumatology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Keishi Fujio
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Ayako Shoji
- Medilead Inc., Tokyo Opera City Tower, Shinjuku-ku, Tokyo 163-1424, Japan
| | - Hiroko Yamaguchi
- Medilead Inc., Tokyo Opera City Tower, Shinjuku-ku, Tokyo 163-1424, Japan
| | - Katsuhiko Iwasaki
- Medilead Inc., Tokyo Opera City Tower, Shinjuku-ku, Tokyo 163-1424, Japan
| | | | - Yuichi Kawata
- Chugai Pharmaceutical Co., Ltd., Chuo-ku, Tokyo 103-8324, Japan
| | | | - Ataru Igarashi
- Department of Health Economics & Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan.,Unit of Public Health and Preventive Medicine, Yokohama City University of Medicine, Yokohama 236-0004, Japan
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Nassiri S, Karimian Z, Tahermanesh K, Farasatinasab M. Surviving surgery; succumbing to pharmacotherapy: A case report underscoring the importance of PRN order clarification for patient safety. J Healthc Risk Manag 2023; 42:40-44. [PMID: 36843570 DOI: 10.1002/jhrm.21534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/09/2023] [Accepted: 01/17/2023] [Indexed: 02/28/2023]
Abstract
"Pro re nata" (PRN) or "as needed" medicine administration and usage is a relatively neglected area in medication management (pharmacotherapy/pharmaceutical care) which contributes to error-prone use of medications and is unsafe for patients. In this case, we report the incident of diclofenac toxicity in a 51-year-old woman due to a prescription of 100 mg diclofenac suppositories PRN, or as needed, for postoperative pain control without explanation of the maximum daily dose (150 mg daily), which led to arbitrary consumption of 3 g of diclofenac over 5 days (600 mg daily) by the patient, and subsequent development of metabolic acidosis, acute kidney injury, and sudden cardiac arrest. The implementation of practical guidelines and training programs for health care workers to appropriately prescribe, dispense, and administer PRN medicines are necessary, and should at least include providing clarification for their indication, dose and frequency, as well as any cautionary instructions to ensure safe and effective use of such medicines.
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Affiliation(s)
- Setare Nassiri
- Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Karimian
- Heidelberg Institute of Global Health, Faculty of Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Kobra Tahermanesh
- Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Farasatinasab
- Department of Clinical Pharmacy, School of Pharmacy-International Campus, Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences, Tehran, Iran
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Wylegała K, Religioni U, Czech M. The Impact of Hospital Pharmacy Operation on the Quality of Patient Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4137. [PMID: 36901140 PMCID: PMC10002066 DOI: 10.3390/ijerph20054137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
This paper presents the role, tasks, and place of a hospital pharmacy in the structure of the entire facility. The role of hospital drug management and pharmacy seems to be extremely important in providing patients with high-quality care. Particular emphasis was placed on the distribution systems of medicinal products and medical devices in the hospital. The advantages and disadvantages of the classical distribution system and modern systems such as unit-dose and multi-dose-and the most important differences between them-are presented. Difficulties related to implementing modern distribution systems in hospitals were also discussed. The information provided is presented in the context of the legal regulations in Poland.
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Affiliation(s)
- Karolina Wylegała
- Chair and Department of Pharmacoeconomics and Social Pharmacy, Medical University of Poznan, 61-701 Poznan, Poland
- Independent Public Healthcare Center in Miedzychod, 64-400 Miedzychod, Poland
| | - Urszula Religioni
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-813 Warsaw, Poland
| | - Marcin Czech
- Department of Pharmacoeconomics, The Institute of Mother and Child, 01-211 Warsaw, Poland
- Business School, Warsaw University of Technology, 00-661 Warsaw, Poland
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Ismail S, Abu Esba L, Khan M, Al-Abdulkarim H, Modimagh H, Yousef C. An Institutional Guide for Formulary Decisions of Biosimilars. Hosp Pharm 2023; 58:38-48. [PMID: 36644755 PMCID: PMC9837324 DOI: 10.1177/00185787221138007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Biologics have changed the landscape for the management of many debilitating chronic diseases but account for a significant expenditure of medications globally. Fortunately, advances in technology paved the way for the introduction of biosimilars, which are highly similar to the originator biologics. In the quest to reduce the budget impact of biologics, organizations have begun to adopt biosimilars. Institutions evaluating biosimilars for inclusion in the hospital formulary must make informed formulary decisions by conducting a thorough review of key elements for evaluation of biosimilars and address the multidimensional aspects during the selection process of different biosimilar products. Therefore, we aim to present an institutional guide of these elements to inform formulary decisions. These key elements include biosimilar evaluation for formulary addition; regulatory approval; substitution, interchangeability, and switching; extrapolation; product characteristics, manufacturing, and supply chain issues; pharmacoeconomic evaluations; traceability, nomenclature, and coding; education; and pharmacovigilance.
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Affiliation(s)
- Sherin Ismail
- Pharmaceutical Care Department, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- University of North Carolina, Chapel Hill, NC, USA
| | - Laila Abu Esba
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- College of pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Pharmaceutical Care Department, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Mansoor Khan
- Pharmaceutical Care Department, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Hana Al-Abdulkarim
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- Doctoral School of Applied Informatics and Applied Mathematics, Óbuda University, Budapest, Hungary
- Drug Policy and Economic Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Hind Modimagh
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- College of pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Pharmaceutical Care Department, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Consuela Yousef
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
- Pharmaceutical Care Department, Ministry of National Guard Affairs, Dammam, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Al Ahsa, Saudi Arabia
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9
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Thomas CM, Peterson J, Ahiskali A, Hamid L, Butts J, Czachura J, Alpern JD. Hospital pharmacy acquisition of nonstocked antimicrobials-current processes and areas for improvement. J Am Pharm Assoc (2003) 2022; 62:1848-1854. [PMID: 36068143 PMCID: PMC9637775 DOI: 10.1016/j.japh.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The delivery of prompt and appropriate antimicrobial therapy for life-threatening infections is an important antimicrobial stewardship measure and a priority for hospitals. OBJECTIVES To better understand U.S. hospital pharmacy stocking processes and acquisition of nonstocked antimicrobials and to identify strategies for improving this process. METHODS This mixed-methods study recruited infectious diseases and antimicrobial stewardship pharmacists. Semistructured interviews with pharmacists in Minnesota were conducted via video conferencing software from January 21, 2021, to March 17, 2021. Audio recordings of the interviews guided survey development and were also transcribed, coded, and qualitatively analyzed. Surveys were distributed throughout the United States via an e-mail listserv, and responses were collected between August 5, 2021, and September 15, 2021. RESULTS Ten interviews and 78 surveys were included in the analysis. Formulary and stocking practices varied based on institution. Stocking decisions were most frequently based on the frequency of use, clinical utility, and cost of antimicrobials. Nonstocked antimicrobials were often ordered from the wholesale distributor but, if needed urgently, acquired from another local institution. Antibacterial agents were the most frequently needed nonstocked antimicrobials, especially those targeting multidrug-resistant gram-negative bacteria. When acquiring nonstocked antimicrobials, barriers include process inefficiencies, cost, availability, and safety concerns. Improved information sharing between local institutions may help improve this process. CONCLUSION In this exploratory study, antimicrobial stocking practices varied within U.S. hospitals. Acquisition of nonstocked, urgently needed antimicrobials from neighboring hospitals may be common; however, this process lacks guidance and is often inefficient. Establishing better mechanisms for information sharing may improve this process and should be explored.
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Affiliation(s)
- Christine M. Thomas
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN
| | | | | | - Lina Hamid
- M Health Fairview, University of Minnesota Medical Center, Minneapolis, MN
| | - Jessica Butts
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Jennifer Czachura
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Jonathan D. Alpern
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN; and Clinical Research Investigator, HealthPartners Institute, Bloomington, MN
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10
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Al-Hemyari SS, Mohamed Noor DA, El-Dahiyat F. Attitude and perception of pharmacists and healthcare professionals about the criteria used in drug formulary selection in the United Arab Emirates. J Pharm Policy Pract 2022; 15:67. [PMID: 36258258 PMCID: PMC9580123 DOI: 10.1186/s40545-022-00460-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/04/2022] [Indexed: 11/12/2022] Open
Abstract
Background There is lack of both resources and expertise explains the limited extent to which pharmacoeconomic evidence is used in formulary decision-making. Objectives The present study aims to assess attitude and perceptions toward the criteria used to select formulary drugs among UAE healthcare organizations. Methods A descriptive cross-sectional study was conducted amongst the licensed physicians in all specialties, all pharmacists and other healthcare professionals with a minimum of 3 month experience those registered with Ministry of health and prevention and those working in the private sector in the UAE. Participants are sent an email containing a validated web-based electronic link to access the questionnaire. The questionnaire composed of two sections is used to assess the healthcare professionals’ attitude and perceptions regarding the criteria used to select formulary drugs. Data analysis were done using SPSS Version 24. Results A total of 866 respondents participated in the study and completed the whole questionnaire. The average attitude score about the criteria used in drug formulary selection was 84.5% with a 95% confidence interval (CI) of [83.9%, 85.4%]. Of the total participants, 27 (3.1%) had poor attitude about the criteria used in drug formulary selection, 240 (27.7%) had moderate attitude and 599 (69.2%) had good attitude. The results of statistical modeling showed that education level, area of expertise and age were jointly highly associated with attitude about the criteria used in drug formulary selection. Conclusions The study revealed that pharmacists and Healthcare professionals had a good attitude about the criteria used in drug formulary selection in the United Arab Emirates. This study purposed to provide Emirate pharmacy and therapeutics policy makers with a clear criterion of best practice related to methodological recommendations to help in increasing the utilization and implementation of pharmacoeconomic evidence in the drug formulary selection process.
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Affiliation(s)
- Sabaa Saleh Al-Hemyari
- Health and Safety Department, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, 11800, Gelugor, Malaysia
| | - Dzul Azri Mohamed Noor
- Health and Safety Department, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, 11800, Gelugor, Malaysia
| | - Faris El-Dahiyat
- Clinical Pharmacy Program, College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates. .,AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates.
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11
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Khardaly AM, Almudaiheem HY, Alkhnaizi G, Eshwi M, Alshennawi M, Alissa DA, Al‐jedai AH. The outcomes of a national clinical review process for n
onformulary
medication requests in Saudi Arabia. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2022. [DOI: 10.1002/jac5.1686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Amr M. Khardaly
- Therapeutic Affairs Deputyship Ministry of Health Riyadh Saudi Arabia
| | | | | | - Mohammed Eshwi
- Therapeutic Affairs Deputyship Ministry of Health Riyadh Saudi Arabia
| | - Mohammed Alshennawi
- Therapeutic Affairs Deputyship Ministry of Health Riyadh Saudi Arabia
- Colleges of Medicine and Pharmacy Al‐Faisal University Riyadh Saudi Arabia
| | - Dema A. Alissa
- Therapeutic Affairs Deputyship Ministry of Health Riyadh Saudi Arabia
- Colleges of Medicine and Pharmacy Al‐Faisal University Riyadh Saudi Arabia
| | - Ahmed H. Al‐jedai
- Therapeutic Affairs Deputyship Ministry of Health Riyadh Saudi Arabia
- Colleges of Medicine and Pharmacy Al‐Faisal University Riyadh Saudi Arabia
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Yang J, Zheng L, Guan YY, Lv YT. Drug and therapeutics committee interventions in managing irrational drug use and antimicrobial stewardship in China. Front Pharmacol 2022; 13:829408. [PMID: 35959424 PMCID: PMC9361011 DOI: 10.3389/fphar.2022.829408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Aim: This study aimed to investigate the key points in the transformation of the functions of the Drug and Therapeutics Committee (DTC) of the Shandong Provincial Third Hospital and how to provide full authority to its role in the control of rational drug use, especially in the management of antibiotic use.Method: A prescription review management group, antimicrobial stewardship group, and rational drug use service group were established under the DTC. From January 2016 to December 2021, each group played a role in promoting rational drug use and antimicrobial stewardship. In addition, we performed statistics on typical management cases, irrational drug use, bacterial resistance rate, and drug costs from 2015 to 2021 to evaluate the effect of management by the DTC.Results: Intervention by the DTC led to a significant reduction in prescribing errors (71.43%, p < 0.05), the intervention acceptance rate increased by 16.03%, and the problem solved rate increased by 32.41% (p < 0.05). Resistance rates of general spectrum antibiotics were reduced remarkably after the intervention. The quality of drug treatment was improved and patient drug expenses was continuously reduced.Conclusion: Giving full play to the functions of the DTC can significantly improve the level of drug treatment and reduce unreasonable drug use to save unnecessary drug expenses and slow the development of drug resistance.
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Affiliation(s)
- Jing Yang
- School of Medicine and Pharmacy, Ocean University of China, Qingdao, China
- Department of Pharmacy, Shandong Medical College, Jinan, China
| | - Lei Zheng
- Department of Pharmacy, Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Lei Zheng, ; Yong-Tao Lv,
| | - Yu-Yao Guan
- Department of Pharmacy, Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yong-Tao Lv
- Department of Pharmacy, Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Lei Zheng, ; Yong-Tao Lv,
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ASHP Standard for Certification as a Center of Excellence in Medication-Use Safety and Pharmacy Practice. Am J Health Syst Pharm 2021; 79:564-599. [PMID: 34729588 DOI: 10.1093/ajhp/zxab368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lam SW, Amoline K, Marcum C, Leonard M. Healthcare system conversion to a biosimilar: Trials and tribulations. Am J Health Syst Pharm 2021; 78:2159-2163. [PMID: 34259801 DOI: 10.1093/ajhp/zxab279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
DISCLAIMER In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE While biologic medications have transformed the care and management of millions of patients, they are a large financial strain on the healthcare system. Biosimilar medications present a great opportunity to improve care affordability. However, despite streamlined approval processes and the potential for cost savings, the acceptance and adaptation of biosimilars have been slow. This descriptive report illustrates the preparation for, challenges, and execution of an enterprise-wide biosimilar conversion within a large healthcare system. The 3 phases of biosimilar conversion utilized at our institution included selection of a biosimilar, pharmacy and therapeutics (P&T) committee approval, and implementation. SUMMARY When selecting a biosimilar, clinical data, medication safety, cost, institutional cost savings, payer coverage, patient assistance programs, and additional patient services should be taken into consideration to ensure patient care is not affected. Understanding and endorsement of biosimilar use by physician leadership, care managers, and pharmacists are crucial before implementation. P&T committee approval with clear delineation of the patient population (naive vs experienced), disease states, and whether the biosimilar would be the preferred medication should be obtained. Transparent communication of clear expectations to patients and coordination with the information technology (IT), contracting, and supply chain departments are necessary before the go-live date. Contracting and IT implementations should ideally take potential changes in biosimilar adaptation into consideration and have enough flexibility to account for these changes. Planned evaluations of patients' experiences with the change to the biosimilar should be incorporated as part of the implementation plan. CONCLUSION The barriers to biosimilar adaptation are plentiful. Careful planning, clear communication, and coordination with all affected disciplines can ensure successful biosimilar conversion.
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Affiliation(s)
- Simon W Lam
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA
| | - Kevin Amoline
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA
| | | | - Mandy Leonard
- Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA
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