Pharmacists part of team to manage chronic disease
A disease
management programme involving 6,000 patients run by US managed health care company Kaiser Permanente has shown that teams of pharmacists, technicians and nurses can improve outcomes and reduce costs in the treatment of dyslipidaemia and hypertension.
Low-density lipoprotein values of less than 3.4 mmol/L were achieved
in 94 per cent of patients in the programme compared with 67 per cent
in a control group. Control of hypertension, as measured by a blood pressure
of less than 140/90mmHg, was achieved in 70 per cent of patients in the
programme compared with 67 per cent in the control.
Other benefits included a 9 per cent reduction in visits to the emergency
department and a 22 per cent decrease in hospital admissions. A survey
reported that 99 per cent of patients are satisfied with the service.
Labour costs per patient involved in managing drug treatment reduced
significantly on implementation of the new model from $720 to $105.
The programme involves nurses performing an initial patient assessment.
Pharmacists then initiate drug therapy and laboratory tests using a protocol,
monitor blood pressure and laboratory results and adjust treatment
accordingly. Pharmacy technicians are also
involved in communicating with patients on maintenance therapy. There
are clear entry and exit criteria for patients and a robust clinical
record system is in place.
This project was awarded one of this year’s American
Society of Health-System Pharmacists Pfizer best practice awards at the ASHP mid-year
clinical meeting in Orlando, Florida, on 5 December. |
The
Pharmaceutical Journal
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