Abstract
Objectives:
To comprehensively classify interventions performed by emergency medicine clinical pharmacists and quantify cost avoidance generated through their accepted interventions.
Design:
A multicenter, prospective, observational study was performed between August 2018 and January 2019.
Setting:
Community and academic hospitals in the United States.
Participants:
Emergency medicine clinical pharmacists.
Interventions:
Recommendations classified into one of 38 intervention categories associated with cost avoidance.
Measurements and Main Results:
Eighty-eight emergency medicine pharmacists at 49 centers performed 13,984 interventions during 917 shifts that were accepted on 8,602 patients and generated $7,531,862 of cost avoidance. The quantity of accepted interventions and cost avoidance generated in six established categories were as follows: adverse drug event prevention (1,631 interventions; $2,225,049 cost avoidance), resource utilization (628; $310,582), individualization of patient care (6,122; $1,787,170), prophylaxis (24; $22,804), hands-on care (3,533; $2,836,811), and administrative/supportive tasks (2,046; $342,881). Mean cost avoidance was $538.61 per intervention, $875.60 per patient, and $8,213.59 per emergency medicine pharmacist shift. The annualized cost avoidance from an emergency medicine pharmacist was $1,971,262. The monetary cost avoidance to pharmacist salary ratio was between $1.4:1 and $10.6:1.
Conclusions:
Pharmacist involvement in the care of patients presenting to the emergency department results in significant avoidance of healthcare costs, particularly in the areas of hands-on care and adverse drug event prevention. The potential monetary benefit-to-cost ratio for emergency medicine pharmacists is between $1.4:1 and $10.6:1.
Document Type
Article
Publication Date
4-26-2021
Digital Object Identifier (DOI)
https://doi.org/10.1097/CCE.0000000000000406
Repository Citation
Rech, Megan A.; Adams, William; Smetana, Keaton S.; Gurnani, Payal K.; Van Berkel Patel, Megan A.; Peppard, William J.; Hammond, Drayton A.; Flannery, Alexander H.; and PHARM-EM Investigators on behalf of the Society of Critical Care Medicine Clinical Pharmacy and Pharmacology Section and endorsed by the Discovery Network, "PHarmacist Avoidance or Reductions in Medical Costs in Patients Presenting the EMergency Department: PHARM-EM Study" (2021). Pharmacy Practice and Science Faculty Publications. 62.
https://uknowledge.uky.edu/pps_facpub/62
Supplemental Digital Content file 1
ccx_1_1_2021_04_15_rech_21-00130_sdc1.pdf (410 kB)
Supplemental Digital Content file 2
Notes/Citation Information
Published in Critical Care Explorations, v. 3, issue 4, e0406.
Copyright © 2021 The Author
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