Clinical Pharmacy Forum
Monday, November 13, 2023
01:00 PM–02:30 PM
Abstract
Service or Program:
The clinical pharmacy specialists at the Primary Care Medicine Clinic (PCMC) at Barnes-Jewish Hospital monitor for drug shortages and state Medicaid changes that would impact patients. The PCMC is a large, academic internal medicine clinic that serves up to 190 patients daily. Pharmacists reviewed patients’ charts, identified affected patients, and contacted providers with alternative recommendations to minimize delays and gaps in medication therapy. Additionally, providers were notified through a memo using an SBAR format. Examples of recent initiatives include glucagon-like peptide-1 agonist, albuterol nebulizer solution, and varenicline drug shortages, and Missouri Medicaid’s restriction of gabapentin dose and short-acting beta agonist inhaler refills.
Justification/Documentation: Medication shortages are surging in the United States and have been associated with negative economic and clinical outcomes to patients. Patients are at risk for increased out of pocket expenses, adverse events, and dissatisfactions during medication shortages. Implementing local mitigation strategies can help minimize adverse outcomes and inconvenience affecting both health professionals and patients. For example, 722 patients were screened for gabapentin dose restriction change in February 2023 and 91 patients were identified needing provider actions and recommendations were sent to their providers prior to the roll out of restriction in April 2023.
Adaptability: Recent updates on drug shortages and discontinuations were obtained through the FDA website and the institution’s drug shortage committee. Medicaid website was referenced for coverage updates. The electronic medical record reporting tool was used to identify patients based on prescribed medication and insurance coverage if applicable. Patient list obtained from the report was used for review and proactive measures highlighted above. This process may be applied to any inpatient and outpatient setting in the health system.
Significance: Vigilant monitoring of drug shortage and coverage updates and proactive measures present opportunities for pharmacists to reduce barriers to continued medication therapies and ensure proper transitions of care.
Presenting Author
Sue Lee-Chuu PharmD, BCPSBarnes Jewish Hospital
Authors
Christine Kelso Pharm.D., BCPS, AE-C
Barnes-Jewish Hospital
Rachel Howland PharmD, BCPS
Barnes Jewish Hospital