Economic impact about the implementation of a pharmaceutical attention program in one emergency department

Abstract

Introduction: Drug Related Problems (DRP) are events or circumstances involved in pharmacotherapy that actually or potentially interfere with desired health outcomes. Improving medication safety has a great potential and that interventions to leverage clinical pharmacists can be expanded as a mechanism to improve medication safety outcomes and also health care resources. Emergency departments (ED) represent the health device that treats more patients after primary care and ambulatory care and are an environment with a particularly high risk to develop DRP. Objective: The objective of this study is to perform an analysis of the economic impact about the implementation of a pharmaceutical attention program (PAP) at the ED. Material and methods: One center, observational, retrospective study that included all the DRP detected prospectively, in a tertiary hospital after the implementation of a PAP in the ED during 30 months. PAP consisted on a daily review of medical prescriptions of patients attended at ED. Results: a total of 3,082 DRP were detected. The potential cost avoidance during the study period rose to 742,779 USD, while the cost of including a clinical pharmacist at the ED was only 18,000 €. A sub analysis about anticoagulant therapy was performed, and a significant reduction of adverse drug events was observed (OR 3.62 IC95 (1.92-6.85), p<0.001 for apparition of adverse events when the pharmaceutical intervention was not accepted), meaning a cost avoidance of 179,641.90 USD. Conclusion: the implementation of PAP in an ED us a cost avoiding initiative. There is a need for developing prospective studies and randomized controlled clinical trials in order to dispose of high quality evidence about the implementation of these kind of programs