Impact of a Drugs & Therapeutics Backgrounder on Docusate Utilization Darren Pasay, B.Sc.Pharm Drug Stewardship Pharmacist (Central Zone)
[email protected] Disclosure I have no actual or potential conflict of interest in relation to this topic or presentation. Drug Stewardship in Alberta Health Services • Drug Stewardship (DS) Team established in 2012 • “The shared responsibility of Drugs & Safety Therapeutics Committee (DTC), prescribers, pharmacy and care units to ensure Sustainability medications are used in a manner that maximizes the effectiveness, safety and sustainability of care for our patients” Effectiveness • Research and project support Drugs & Therapeutics Backgrounders (DTBs) • Frontline staff wanted background and support on DTC/formulary issues1 • One page document, meant to enhance conversations with prescribers • Supported by content experts, based upon DTC directions • Published 6 times/year • Followed by 2 interactive webinars for each edition 1. Pasay Darren K, Chow Sheldon JS, Bresee Lauren C, Guirguis Micheal, Slobodan Jeremy. Assessment of current antimicrobial stewardship policies and resources: a focus group project. Healthcare Infection 2015; 20: 7–15. Docusate • Over-the-counter stool softener • It is clear, based on published peer-reviewed literature, that docusate is ineffective for the prevention or treatment of constipation • Open listed on AHS Provincial Drug Formulary • Limited coverage on Alberta Drug Benefit List (palliative care only) Docusate DTB • Preliminary work o ~ 2 million doses/year dispensed • Influences o Some LTC sites have eliminated o Engrained in practice use already • Part of pharmacy, medicine, nursing curriculums • Order sets, Pre-printed care • What are the costs of? orders (PPCO) o Procurement o Seen as innocuous, safe o Processing, dispensing o Medication administration o Medication burden BOTTOM LINE: Docusate is no more effective than placebo for the prevention and treatment of constipation.