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Created by CPA's team of experienced clinical pharmacists using FDA Center for Drug Evaluation and Research (CDER) and other supplemental expert resources.
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IN THIS ISSUE |
February 2012 |
 Breaking News:
The American College of Healthcare Executives (ACHE) has featured the collaboration between Sibley Hospital and CPA in the most recent CEO Newsletter. Read more about it in our Commentary Spotlight.
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Journal Review
A critical review of important journal articles from healthcare experts.
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Emergency Hospitalizations for Adverse Drug Events in Older Americans
D. S. Budnitz DS, Lovegrove MC, Shehab N et al.
N Engl J Med 365:2002-12, November 24, 2011
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P&T on DemandSM
CPA provides complete examples of our independent proprietary analytics with committee ready reports and analyses.
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New Drug Evaluation / Monograph
FIDAXOMICIN (DIFICID)
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New Drug Classification Report
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Commentary Spotlight
Authoritative reports to assist healthcare professionals make decisions and solve problems
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Medication Reconciliation = Medication Safety, Care Improvement, and Cost Savings
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CPA Journal Club |
February 2012 |
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Journal Review
Emergency Hospitalizations for Adverse Drug Events in Older Americans
D. S. Budnitz DS, Lovegrove MC, Shehab N et al.
N Engl J Med 365:2002-12, November 24, 2011
As members of the elderly population in the United States live longer, new healthcare concerns have become evident. Coexistent clinical conditions, age-related physiological changes, chronic illnesses and polypharmacy have increased the risk of adverse drug events. The rate of hospitalization for adverse drug events will likely increase as the patient population gets older. A reduction in the number of preventable rehospitalizations by 20% in 2013 is a goal of the $1 billion federal initiative Partnership for Patients. Adverse drug events are a significant focus for this Partnership program. This study utilizes national surveillance data on emergency hospitalizations to estimate the frequency of admissions due to adverse drug events in the elderly. The results of the survey and an analysis of the study data are discussed.
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P&T on DemandSM
New Drug Evaluation / Monograph
FIDAXOMICIN (DIFICID)
Clostridium difficile (C. difficile) is a gram positive anaerobic bacillus, which has become increasingly problematic in the community, hospitals, nursing homes, and other long-term care facilities. C. difficile is responsible for 10–25% of antibiotic-associated diarrhea, 50–75% of antibiotic-associated colitis, and 90–100% of antibiotic-associated pseudomembranous colitis. Nosocomial C. difficile infection (CDI) results in an increased length of stay in the hospital, ranging from 8 to 21 days. The mortality rate of Clostridium difficile–associated disease (CDAD) ranges from 6–30% when pseudomembranous colitis is present and can be high even in cases in which colitis is presumed, but not proven. Fidaxomicin is a new, narrow spectrum, macrocyclic antibiotic that has favorable activity against
C. difficile.
New Drug Classification Report
The New Drug Classification Report is a monthly committee ready report providing new FDA-approved medications in addition to new indications, new dosage formulations, mechanisms of action, warnings and common adverse events, dosage and administration, costs, and a list of therapeutic alternatives. This report assists in defining time-lines for formulary review. It lists new drugs and formulations with their alternatives. The New Drug Classification Report tracks through the 15th of each month and provides a rating system to allow immediate P&T Committee action. It is also beneficial to practitioners who want to keep up to date on new therapies.
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Commentary Spotlight
Medication Reconciliation = Medication Safety, Care Improvement, and Cost Savings
As new and complex drugs have improved and extended life for patients confronting an array of diseases and medical conditions that had previously eluded treatment, and as the number of medications used by patients – particularly seniors – has risen significantly, the challenge for health care practitioners is to manage medications in a way that can reduce adverse events and eliminate medication errors.
When it comes to medication reconciliation, what really matters is timely expertise. Data must be coupled with information from traditional sources (e.g. patient, family, referring physician) to give the caregiver maximum knowledge.
Clinical Pharmacy Associates (CPA) recently partnered with Sibley Memorial Hospital, a member of Johns Hopkins Medicine in Washington, D.C., to assess a new enhancement in medication reconciliation that it had designed. The results from this assessment demonstrated a better way to approach the medication reconciliation process, one that may be less complicated and less difficult to implement than you would think. Our efforts have led to the development of a pilot program that combines virtual and on-site collaboration with integration to the hospital’s emergency department (ED) electronic health record, which may ultimately lead to broad-scale implementation at the hospital.
Read the Commentary | ACHE CEO Newsletter Q&A
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CPA Safety News and Notes
Essential issues in medication safety
Safety Brief on Study Supporting Need for Ambulatory Care High-Alert Drug List from Institute for Safe Medication Practices (ISMP)
A November 2011 study from adverse drug events data collected from 2007-2009 estimated that nearly100,000 elderly patients are hospitalized each year due to these events. Unintentional overdosage is the primary cause of hospitalizations and emergency room visits in this population. In addition to its Ambulatory Care High-Alert Drug List, ISMP is currently designing patient education materials [an Agency for Healthcare Research and Quality (AHRQ) funded project] to support mandatory patient education by community pharmacies for approximately a dozen selected high-alert drugs. These materials are expected to be freely available for inpatient and outpatient settings by the summer of 2012.
Click here for article
Bicycling and Other Exercise May Help People With Parkinson’s Curb Their Symptoms
Ongoing studies relating to the effects of strenuous exercise for reduction of Parkinson’s symptoms are showing promise. Since Parkinson’s disease kills brain cells that produce dopamine, a chemical which enables neurons to communicate with muscles, loss of small and large motor skills, i.e. mobility is affected. Some researchers in the field believe that more exercise, which provides survival for dopamine-producing cells, can slow the loss of mobility. Brain scans on patients with Parkinson’s disease who participated in strenuous cycling exercise three times a week showed increased blood flow and brain activity as effective as medications currently routinely prescribed for Parkinson’s disease patients.
Click here for article
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