Scientific Poster Session I - Clinical Pharmacy Forum

Abstract

The transition of care of blood factors to the pharmacy allows clinical pharmacy involvement with products including Factor VIII, Factor VIII/von Willebrand Factor Complex, Factor IX, Factor VII, antithrombin, and prothrombin complex concentrate, mainly within emergency rooms and intensive care units or elective surgeries for patients with bleeding disorders like hemophilia A or B and von Willebrand disease. Previously at West Virginia University Hospitals, hematology fellows in the blood bank managed all blood factor products with no pharmacy involvement. The development of this program included addition of a benign/hematology clinical pharmacist, formulary reviews, budget impact analyses, guideline development, and operational standardization. Continuing education, operational presentations, required case-based learning, and nurse-and physician electronic handouts were incorporated for education purposes.

Justification/Documentation:

Several safety concerns exist with medications not being managed by clinical pharmacists. Previously, products were used with no clinical oversight and follow up regarding appropriate choice or switching of agents. Products were being used inappropriately in patients without bleeding disorders or on prior anticoagulation triggering development of restriction criteria depending on the dosing frequency, indication, and cost. Collaboration with the EPIC Willow team allowed for minimization of safety events such as naming conventions, access to resources, and optimization of the orders through radio buttons. Measurement of success is generated through dashboards created to monitor usage, appropriateness, and cost management to improve patient care.

Adaptability:

This initiative provides guidance for other health systems to develop pharmacy involvement in institutions that utilize their blood bank for blood factor products with limited pharmacy integration.

Significance:

Blood factor management by pharmacy allows for more judicious use of these products as pharmacists are uniquely positioned to provide safe, appropriate, and cost-effective use by thoroughly reviewing medication histories and providing clinical services. Involvement with blood factor utilization will significantly improve patient care and enhance the hospital system budget.

Presenting Author

Authors