The Development of an Enhanced Palliative Care Pharmacy Service during the Initial COVID-19 Surge
Abstract
:1. Introduction
Outlining the Need for Service Development
2. Materials and Methods
2.1. Details of the Service
2.2. Aims and Objectives
2.3. Study Design
2.3.1. Palliative Care Pharmacist Activities and Quality of Care
2.3.2. Economical Assessment
Cost Avoidance
Length of Stay
3. Results
3.1. Palliative Care Pharmacist Activities and Quality of Care
3.2. Economic Impact
3.2.1. Cost Avoidance
3.2.2. Length of Stay
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Ranking | Description |
---|---|
Grade 1 | Detrimental to patient’s well being e.g., removing drug or decreasing dose inappropriately |
Grade 2 | No significance to patient care e.g., endorsing generic drug names |
Grade 3 | Significant, but does not lead to an improvement in patient care e.g., requests for change in treatment on cost basis |
Grade 4 | Significant and results in an improvement in the standard of care e.g., getting omitted drugs added to kardex |
Grade 5 | Significant and prevents major organ failure or adverse reaction of similar importance e.g., calculation of aminoglycoside dose with impaired renal function |
Grade 6 | Potentially life-saving e.g., life threatening drug interaction |
Cost Avoidance ScHARR Model GBP | Eadon Criteria Ranking | |
---|---|---|
Potentially Lethal | 1085–2120 | 6 |
Potentially Serious | 713–1484 | 5 |
Potentially Significant | 65–150 | 4 |
Minor | 0–6 | 1–3 |
Month | Total Number of Patients | Number of Patient Visits | Mean Number Visits/Patient | % COVID Patient | % End of Life Care Patient |
---|---|---|---|---|---|
April | 81 | 278 | 3.4 | 33% | 69% |
May | 68 | 215 | 3.2 | 16% | 66% |
June | 45 | 124 | 2.8 | 4% | 67% |
Common Activity Themes for Palliative Care Pharmacy Team |
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Month | Total Number Interventions | Mean No. Interventions/Patient | Grade 3 | Grade 4 | Grade 5/6 | |||
---|---|---|---|---|---|---|---|---|
Total | % | Total | % | Total | % | |||
April | 517 | 6.4 | 117 | 23 | 367 | 71 | 33 | 6 |
May | 481 | 7.1 | 56 | 12 | 400 | 83 | 25 | 5 |
June | 311 | 6.9 | 24 | 8 | 270 | 87 | 17 | 5 |
Mean * | 436 | 6.8 | 15 | 80 | 5 |
Eadon Grade | Mean Number of Interventions per Month per Grade | ScHARR Cost Avoidance (Taken as Mid-Point of Range, GBP) | Total Estimated Cost Avoidance per Month per Grade (GBP) |
---|---|---|---|
3 | 65.4 | 3 | 196 |
4 | 348.8 | 108 | 37,670 |
5 | 21.8 | 1099 | 23,958 |
Total Estimated Cost Avoidance | GBP 61,824/month | ||
Total Estimated Cost Avoidance Adjusted for Patients not at end of life (i.e., 33%) | GBP 20,402/month |
Anticipated Mean no. Patients per Month = 45 (for 1 Full-Time Equivalent Pharmacist) | ||||
---|---|---|---|---|
Estimated No. Interventions/Patient = 6.8 (Rounded Down to Nearest Whole Number = 6) | ||||
Eadon Grade | % of Total Interventions/Month | Anticipated Number of Interventions per Month | ScHARR Cost Avoidance (Taken as Mid-Point of Range, GBP) | Total Potential Cost Avoidance (GBP) |
3 | 15 | 40.5 | 3 | 122 |
4 | 80 | 216 | 108 | 23,328 |
5 | 5 | 13.5 | 1099 | 14,837 |
Total Potential Cost Avoidance | GBP 38,287/month | |||
Total Potential Cost Avoidance Adjusted for Patients not at end of life (i.e.,33%) | GBP 12,635/month |
Number of Patients Reviewed | % Patients Who Died in Hospital | Average LOS (Days) | Average LOS in Patients Discharged | |
---|---|---|---|---|
Review or Intervention by PC Pharmacist | 20 | 35% | 8.75 (range 2 to 26) | 7.9 (range 2 to 15) |
No Review or Intervention by PC Pharmacist | 27 * | 48% | 10 (range 2 to 29) | 11.8 (range 2 to 29) |
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Hanley, J.; Spargo, M.; Brown, J.; Magee, J. The Development of an Enhanced Palliative Care Pharmacy Service during the Initial COVID-19 Surge. Pharmacy 2021, 9, 196. https://doi.org/10.3390/pharmacy9040196
Hanley J, Spargo M, Brown J, Magee J. The Development of an Enhanced Palliative Care Pharmacy Service during the Initial COVID-19 Surge. Pharmacy. 2021; 9(4):196. https://doi.org/10.3390/pharmacy9040196
Chicago/Turabian StyleHanley, Jaquie, Maureen Spargo, Joanne Brown, and Julie Magee. 2021. "The Development of an Enhanced Palliative Care Pharmacy Service during the Initial COVID-19 Surge" Pharmacy 9, no. 4: 196. https://doi.org/10.3390/pharmacy9040196