Clinical Pharmacy Forum
Monday, October 14, 2024
01:00 PM–02:30 PM
Abstract
Service or Program: The clinical pharmacy service provided is a prospective utilization evaluation of patient eligibility, drug dosing, tolerability, and monitoring for adverse events related to psychotropic long-acting injectable medications (LAIs). It is performed in an acute care specialty hospital to support patients, prescribers, and the hospital. The therapies are used in patients who are either agreeable to the injection or who are initiated after court mandate. Pharmacists provide the service, which was a development by the Pharmacy Director who also acts as a Clinical Pharmacist.
Justification/Documentation: The service is meeting a need for support with patient safety and therapeutic optimization, especially in treatment refractory or non-adherent patients. LAI options have recently expanded and are becoming mainstays. Gaps in prescriber knowledge related to their differences have been identified, and our pharmacists are leveraging specialty training to remedy this.
Adaptability: The service is adaptable to settings where pharmacists evaluate use of or dispense LAIs, including hospitals and administration clinics. It may be delivered by equivalently qualified providers since it includes a decision tree and summary checklist of data points extracted from package inserts. It is likely to be successfully implemented elsewhere due to ease of use.
Significance: Before LAI utilization evaluation was required at our hospital, random and retroactive reviews showed discrepancies in tolerability establishment, dosing, and/or oral supplementation that compromised therapeutic efficacy. After evaluation became required, reconciliation of such discrepancies has led to successful initiations of therapy that increase adherence potential in treatment-refractory patients which positions clinical pharmacists squarely in a role that is key for optimization of patient care. Further, the value of our pharmacist interventions upon prospective review has been so well received that more instances of pharmacist consultation by prescriber at order submission are emerging. Additionally, the hospital may be positively impacted by decreased inpatient length of stay and readmissions in LAI patients.
Presenting Author
Sparkle Box Doctor of Pharmacy
NeuroBehavioral Hospital of Northwest Indiana and Greater ChicagoAuthors