Pharmacist value-added to neuro-oncology subspecialty clinics: A pilot study uncovers opportunities for best practices and optimal time utilization
| Autor: | Durga Zally, Erika Leese, Benjamin Andrick, Na Tosha Gatson, Anupama Divakaruni Mathur, Grant W Lee |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Neuro oncology Best practice Pharmacist Pharmacy Pilot Projects Subspecialty Medical Oncology Pharmacists Ambulatory Care Facilities 03 medical and health sciences 0302 clinical medicine Medication Reconciliation Cost Savings Physicians Medicine Humans Pharmacology (medical) 030212 general & internal medicine health care economics and organizations Pharmacist intervention business.industry Time optimal Oncology Family medicine Value (economics) business 030217 neurology & neurosurgery |
| Zdroj: | Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners. 26(8) |
| ISSN: | 1477-092X |
| Popis: | Purpose To evaluate neuro-oncology clinician time utilization for medication management and identify a cost beneficial role for integration of a dedicated pharmacy specialists. Methods A pharmacist was temporarily integrated into a neuro-oncology clinic for a 30-day period to evaluate the clinical practice and perform a 14-day clinical chart evaluation and patient interactions as part of a single institutional exploratory analysis. The pharmacist completed screenings for drug-drug interactions, new therapies, medication reconciliation, and advanced interventions as part of a collaborative practice agreement for pharmacist autonomy. Pharmacist time spent was calculated and documented within the patient encounters to support physician decision-making. A comparative estimate of pharmacist versus physician time utilization and cost for each was completed to derive a savings analysis for integration of a dedicated clinic pharmacist. Result During the 14-day clinical assessment, the pharmacist completed 147 encounters with 338 interventions. Of the encounters, 90% (n = 132) were higher complexity requiring plan modification, and approximately 48% (n = 162) of all interventions required ≥10 minutes of the pharmacist’s time. Physician non-patient-facing time devoted to medication tasks was 5-hours weekly (0.125 FTE, full time equivalents), an estimated direct salary cost of $937/week ($45,000 yearly). Hire of a part-time pharmacist at 0.50 FTE would cover the clinical need with supported documentation and medication monitoring at a cost of $45,000/year. Conclusion Defining the roles for dedicated neuro-oncology clinic pharmacists allows for cost-savings through re-allocation of physician time and improves subspecialty clinic operations as well as patient care. |
| Databáze: | OpenAIRE |
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