Lexicomp has a new Drug ID module for their suite of mobile applications.
New Drug ID mobile module! Video shows fast & simple interface that IDs loose drugs based pill & capsule features. http://t.co/GCBvOoi6af— Lexicomp (@Lexi_Comp) October 13, 2014
Based on the Tweet I thought the new application would identify “loose drugs” with the camera on a mobile device like Medsnap, but that’s not the case.
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So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….
The coffee mug to the right isn’t one of my personal mugs. Instead it’s the kind of generic mug you get in cheesy hotel restaurants. And that’s because I’m not at home. I’m in Las Vegas for my daughter’s volleyball tournament. In lieu of that, and the fact that I had to crawl off into a “quiet†corner to open my laptop, I’m going to make this quick.
Jack the Giant Slayer was #1 at the box office last weekend. Not a big surprise as again there was little in the way of competition at the box office for a second week in a row. Jack brought in a measly $27 Million on its opening weekend. Not too bad, but when you consider the $195 Million production budget that makes it a flop. Yikes! My family and I saw Jack over the weekend. We enjoyed it. Identity Thief continues to do well as it came in second place for weekend box office totals.
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No big surprise here. An study that used pharmacists to “[provide] perspectives on admission and discharge medication reconciliation, in-hospital patient counseling, provision of simple medication adherence aids (eg, pill box, illustrated daily medication schedule), and telephone follow-up” found that “pharmacists are well positioned to participate in hospital-based medication reconciliation, identify patients with poor medication understanding or adherence, and provide tailored patient counseling to improve transitions of care“. Makes sense, don’t you think? After all, that’s what pharmacist do. They deal with medications. All things to do with medications, which includes medication reconciliation.
When I was in pharmacy school at UCSF fourth year pharmacy students were responsible for medication reconciliation. Each “general medicine” team had a fourth year pharmacy student on it, and when there was a new admission the student would interview the patient and reconcile their medication lists. Then we’d simply place the reconciled list in the chart for the attending. When it was time for discharge we’d do it all over again. Often times we’d go as far as to get the discharge prescriptions filled at the outpatient pharmacy and deliver them to the patient bedside where we would provide consultation and education before the patient went home. Pretty cool stuff. This is how it should be done at every hospital. Just sayin’.
Interesting abstract from Presse Medicale (Paris, France) talking about medication reconciliation on an internal medicine unit in a French hospital. The authors found lots or discrepancies, which isn’t a surprise. They also found that pharmacists could help identify and correct many of the discrepancies, which also isn’t a surprise.
Like many other articles I’ve read recently, this one is from data collected quite a while ago. The information was obtained from 61 patients between  June and October 2010. The article is from the March 2012 issue of the journal. I always marvel at how long it takes study results to get published.
The Annals of Pharmacotherapy March 20121
BACKGROUND: Medication reconciliation aims to correct discrepancies in medication use between health care settings and to check the quality of pharmacotherapy to improve effectiveness and safety. In addition, medication reconciliation might also reduce costs.
OBJECTIVE: To evaluate the effect of medication reconciliation on medication costs after hospital discharge in relation to hospital pharmacy labor costs.
METHODS: A prospective observational study was performed. Patients discharged from the pulmonology department were included. A pharmacy team assessed medication errors prevented by medication reconciliation. Interventions were classified into 3 categories: correcting hospital formulary-induced medication changes (eg, reinstating less costly generic drugs used before admission), optimizing pharmacotherapy (eg, discontinuing unnecessary laxative), and eliminating discrepancies (eg, restarting omitted preadmission medication). Because eliminating discrepancies does not represent real costs to society (before hospitalization, the patient was also using the medication), these medication costs were not included in the cost calculation. Medication costs at 1 month and 6 months after hospital discharge and the associated labor costs were assessed using descriptive statistics and scenario analyses. For the 6-month extrapolation, only medication intended for chronic use was included.
RESULTS: Two hundred sixty-two patients were included. Correcting hospital formulary changes saved €1.63/patient (exchange rate: EUR 1 = USD 1.3443) in medication costs at 1 month after discharge and €9.79 at 6 months. Optimizing pharmacotherapy saved €20.13/patient in medication costs at 1 month and €86.86 at 6 months. The associated labor costs for performing medication reconciliation were €41.04/patient. Medication cost savings from correcting hospital formulary-induced changes and optimizing of pharmacotherapy (€96.65/patient) outweighed the labor costs at 6 months extrapolation by €55.62/patient (sensitivity analysis €37.25-71.10).
CONCLUSIONS: Preventing medication errors through medication reconciliation results in higher benefits than the costs related to the net time investment.
Based on the exchange rate mentioned in the study (EUR 1 = USD 1.3443) the six month savings associated with medication reconciliation was about $75 U.S. per patient after factoring in labor. Not exactly earth shattering, but nothing to turn your back on either. At least there’s a positive ROI.
I would have liked to have seen the authors take the study one step further by linking the medication reconciliation savings back to hospitalization readmission and/or effect on the patient’s lifestyle/activity. Once in a while optimizing a patient’s therapy might mean trading a more expensive drug for ease of use or improved patient compliance.
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