Outcomes improve and there can be significant cost savings when infusion pharmacists monitor patients receiving home-based infusion and intervene when dose adjustments are necessary, according to a Walgreens outcomes analysis study being presented at IDWeek 2013™ in San Francisco.
The retrospective analysis conducted by Walgreens Infusion Services involved 257 home-infusion patients who had received intravenous antibiotics such as vancomycin or aminoglycosides, and found that proactive infusion pharmacist interventions resulting from consistent, intensive monitoring and care led to improved clinical outcomes 95.8 percent of the time. The analysts estimated that when the infusion pharmacists intervened and made adjustments in the therapy, there was an associated estimated potential savings of more than $150,000 by preventing adverse health effects.
"Ensuring that patients are receiving the optimal dose is key, as too much medication can cause serious side effects such as kidney damage and hearing loss, and too little is ineffective," said Steve Kennedy, PharmD, national director of Infusion Pharmacy Services for Walgreens Infusion Services.
In most cases, infusion therapy involves the administration of medication into a vein. Walgreens infusion pharmacists closely and regularly monitor the levels of these medications in patients' blood. When levels are inappropriate, Walgreens pharmacists recommend therapy modifications, such as changes in dose, frequency or duration of infusion. They also provide other guidance, such as recommending a change in medication if the infection is not responding, managing adverse medication side effects or preventing drug interactions.
"Walgreens infusion pharmacists are dedicated to providing patients with personalized care and support," said Paul Mastrapa, president of Walgreens Infusion Services. "They proactively go above and beyond what is required, and as a result, patients benefit through improved outcomes and the health care system benefits by avoiding costs associated with treating the consequences of inappropriate therapy."
During the six-month period reviewed, involving 257 randomly selected patients, Walgreens infusion pharmacists recommended 101 interventions, all of which were provided for approval to the patients' physicians before they were made. The patients' doctors accepted 97 of those recommendations (96 percent). Of the accepted recommendations, 93 (95.8 percent) resulted in improved clinical outcomes, meaning the appropriate blood medication levels were reached as a result.
The analysts estimated that each intervention saved approximately $1,623 on average in health care cost avoidance, totaling an estimated $150,933. Based on outcomes analysis and Walgreens Infusion Services annual antibiotic patient census, analysts estimate these types of interventions could save the healthcare system $10.8 million every year.