News

Multidisciplined process redesign: A collaborative approach to system-wide electronic medication reconciliation improvement

Medication errors and adverse drug events (ADEs) pose large threats to patient wellbeing and safety. Medication errors are the most common errors occurring in hospitals. Preventable ADEs are linked with 1 in 5 injuries or deaths. Medication errors occur at key points of transition during the hospital stay. 4-6 At one institution, failure to reconcile medications at transition points accounted for 50% of all medication errors and 20% of ADEs. Medication errors and ADEs are harmful, but also costly to the patient and the healthcare system.7 Complete and accurate medication reconciliation is crucial for reducing medication errors and ADEs

Study shows patient satisfaction with pharmacy program

Implementation of a pharmacy service that provides dosing, monitoring, education, and ensured safe transition from the inpatient to the outpatient setting is associated with improved patient satisfaction with overall care and with care related to anticoagulation management, according to a study published in the Annals of Pharmacotherapy.

Standards of medical care in diabetes: focus on updated recommendations in hospitalized patients

Although the prevalence of diabetes mellitus in hospitalized patients remains unknown, an estimated one-fourth of inpatients experience hyperglycemia.1 Hyperglycemia is linked to poor health outcomes, and there is evidence that intensive glucose control in the hospital reduces mortality, need for dialysis, infections, and length of stay.2 The American Diabetes Association (ADA) publishes clinical practice guidelines annually, which offer clinicians, patients, researchers, and payers current, evidence-based recommendations on all components of diabetes care, general treatment goals, and tools to evaluate the quality of care. The updated guidelines focus on changes in the recommendations for care of the hospitalized diabetes patient.

Specialty drugs are critical focus for payers

The appropriate use of specialty drugs is a major priority for health plans and will become increasingly important for future growth over the next 3 to 5 years, according to a comprehensive survey on payer approaches to specialty drugs. Furthermore, the research finds significant variation in what health plans view as emerging areas of opportunity to manage these drugs.

Efficiency, less utilization fuels US drug spending decline

Total spending on medicines declined by 3.5 percent, according to the IMS Institute for Healthcare Informatics report, Declining Medicine Use and Costs: For Better or Worse?” report. In addition, nominal pharmaceutical spending reached $325 billion in 2012, or real per capita spending of $898, a decline of one percent.

New molecular entity: Canagliflozin

On March 29, 2013, FDA approved canagliflozin (Invokana, Janssen Pharmaceuticals, Inc.), a once-daily tablet, indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

New oral contraceptives increase women’s cardiac risk

Women taking fourth-generation oral contraceptives, which use a progestin that is antiandrogenic, are at increased heart risk. The drugs significantly lengthen the corrected QT (QTc) by 3.6 milliseconds, according to a recent study in the Annals of Noninvasive Electrocardiology.

Newer whooping cough vaccines less effective than older vaccines

Teenagers who received DTaP (acellular pertussis vaccine) in their first 2 years of life had a 6 times higher risk of contracting pertussis compared with those who received DTwP (whole-cell pertussis vaccine) in their first 2 years of life, according to a study online in Pediatrics.

Increased cardiac risks in COPD with new Rx inhalers

Older patients with chronic obstructive pulmonary disease (COPD) may be at increased risk for cardiovascular events with newly prescribed long-acting beta-agonists (LABAs) and long-acting anticholinergics (LAAs) and need to be followed closely by their healthcare providers, according to a study published online May 20 for JAMA Internal Medicine.

Underdosing in obesity-an epidemic: Focus on anticoagulation

Obesity is a growing problem in the United States. Currently, 68% of adult Americans are overweight (BMI >25 kg/m2).1 Of those, 35% are obese (BMI >30 kg/m2) and 6% are morbidly obese (BMI >40 kg/m2). It is estimated that by 2030, 51% of the population will be obese and 11% will be morbidly obese.1 We are often confronted with dosing drugs in an obese patient. Unfortunately, many clinical trials exclude or have limited overweight patients enrolled; thus, optimal dosing for both safety and efficacy in this population is lacking. Pharmacokinetic studies in obese patients have shown that the volumes of distribution of lipophilic drugs and the clearance of hydrophilic drugs can be increased. For this reason, dosing in obesity should be patient- and drug-specific.

Great States

Innovative state experiments propel health reform forward

Risk adjustment audits can actually be helpful

RADV audits can help by confirming that a plan has actually captured the most accurate and complete diagnostic information about its members to deliver the right care to those members based on their needs

Disinfecting all ICU patients significantly reduces MRSA

Decolonization of all intensive care unit (ICU) patients with antimicrobial soap and ointment significantly reduces all bloodstream infections, including methicillin-resistant Staphylococcus aureus (MRSA), according to a study published in the New England Journal of Medicine.