DOCSLIB.ORG

Managing Medicine Selection 17 Treatment Guidelines and Formulary Manuals Procurement Distribution Use

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Managing Medicine Selection 17 Treatment Guidelines and Formulary Manuals Procurement Distribution Use Part I: Policy and economic issues Part II: Pharmaceutical management Part III: Management support systems Selection 16 Managing medicine selection 17 Treatment guidelines and formulary manuals Procurement Distribution Use chapter 16 Managing medicine selection Summary 16.2 illustrations 16.1 Introduction 16.2 Figure 16-1 The essential medicines target 16.7 Figure 16-2 Common health problems guide selection, training, 16.2 Practical implications of the essential medicines supply, and medicine use 16.9 concept 16.2 Figure 16-3 Sample form for proposing revisions in essential 16.3 Selection criteria 16.4 medicines lists 16.12 16.4 Use of International Nonproprietary (generic) Table 16-1 Advantages of a limited list of essential Names 16.5 medicines 16.4 Table 16-2 Example of level-of-use categories, Ethiopia 16.5 Essential medicines lists in context 16.6 Essential Drugs List, fifth edition, 2007 16.6 Lists of registered medicines • Formulary manuals • Table 16-3 Key factors in successfully developing Treatment guidelines and implementing an essential medicines 16.6 Approaches to developing essential medicines lists, program 16.14 formularies, and treatment guidelines 16.8 box 16.7 Therapeutic classification systems 16.10 Box 16-1 WHO criteria for selection of essential 16.8 Sources of information 16.13 medicines 16.5 16.9 Implementing and updating essential medicines lists 16.14 country studies Reasons for failure • Gaining acceptance of essential CS 16-1 Approaches to updating essential medicines and medicines lists • Authority of essential medicines lists formulary lists 16.10 Assessment guide 16.15 CS 16-2 Updating the National Essential Medicines List of Kenya 16.11 References and further readings 16.15 Glossary 16.16 copyright © management sciences for health 2012 16.2 selection SUMMARY The rationale for selecting a limited number of essen- The process of selecting essential medicines begins with tial medicines is that it may lead to better supply, more defining a list of common diseases for each level of health rational use, and lower costs. Essential medicines are care. The treatment of first choice for each health prob- those that are deemed to satisfy the health care needs of lem is the basis for the list of essential medicines, the the majority of the population and that should be avail- national formulary system, and the treatment guidelines. able in the appropriate dosage forms and strengths at The supply system should then supply the medicines that all times. Because selection of medicines has a consid- have been selected, based on this series of steps. erable impact on quality of care and cost of treatment, Essential medicines should be selected on the basis of it is one of the most cost-effective areas for interven- (1) relevance to the pattern of prevalent diseases, (2) tion. proven efficacy and safety, (3) adequate scientific data A list of essential medicines may be selected for use in and evidence of performance in a variety of settings, one or more health facilities or for the public sector as (4) adequate quality, (5) favorable cost-benefit ratio, a whole. In the latter case, the list usually indicates the (6) desirable pharmacokinetic properties, (7) possibili- level of the health care system where each medicine ties for local manufacture, and (8) availability as single may be used. It can also be considered a supply list. compounds. The drugs should be identified by the A formulary system is part of the medicine selection International Nonproprietary Name (INN), sometimes process. The system includes a formulary list, which referred to as the generic name. is ideally based on an essential medicines list, and a General acceptance of an essential medicines list can be formulary manual, which contains summary informa- promoted by wide consultation with senior specialists tion on each medication on the formulary list. Standard and experts, including professional organizations and treatment guidelines are systematically developed state- academic institutions, on the list’s development and use. ments that assist prescribers in deciding on appropri- An open and transparent system of regular updates is an ate treatments for specific clinical problems. Whereas absolute prerequisite for maintaining the authority and a formulary manual is medicine centered, treatment acceptance of an essential medicines list or formulary list. guidelines are disease centered, presenting treatment The essential medicines concept can be applied in any alternatives and recommending a treatment of first country, in the public and private sectors, and in rural choice. areas as well as at referral hospitals. 16.1 Introduction able, prescribers often find it impossible to keep their knowl- edge up-to-date and to compare alternatives. In addition, Pharmaceuticals may constitute as much as 40 percent of the variety of available products may contribute to inconsis- the health care budget in developing countries, yet large tent prescribing within the same health care system or even portions of the population may lack access to even the most in the health facility. With regard to procurement, purchas- essential medicines. The limited funds available are fre- ing power is significantly lessened by the large number of quently spent on ineffective, unnecessary, or even danger- duplicative and nonessential pharmaceutical products on ous medications. the market. As much as 70 percent of pharmaceuticals on the world In short, pharmaceuticals can provide great benefits, but market are duplicative or nonessential. Many are minor their cost is substantial. The selection of medicines has a variations of a prototype drug product and offer no thera- considerable impact on the quality of care and the cost of peutic advantage over other medicines that are already treatment, and it is therefore one of the areas where inter- available. Some are medications that show high toxicity rela- vention is most cost-effective. tive to their therapeutic benefit. In some cases, new medi- cines are released without sufficient information on efficacy or toxicity. Finally, new products often are for therapeutic 16.2 Practical implications of the essential indications not relevant to the basic needs of the population. medicines concept In all of these cases, the newer medicines are nearly always more expensive than existing medicines. The World Health Organization (WHO) has defined With so many different pharmaceutical products avail- essential medicines as those that satisfy the needs of the 16 / Managing medicine selection 16.3 majority of the population and therefore should be available system. Many international organizations, including the at all times. The rationale for the selection and use of a limited United Nations Children’s Fund (UNICEF) and interna- number of essential medicines is that it leads to an improved tional nonprofit supply agencies, have adopted the essential supply of medicines, more rational prescribing, and lower medicines concept for their supply systems. costs; in fact, the appropriate use of essential medicines is Third, when the limited list of essential medicines repre- one of the most cost-effective strategies a country can enact. sents prescribers’ consensus on pharmaceutical treatments The essential medicines concept is a global concept that of first choice, its use may improve the quality of care by can be applied in any country, in the private and public ensuring that patients receive the treatment of choice as sectors, in referral hospitals as well as primary health care well as similar treatment from different providers. It also units, and in both urban and rural areas. However, the deci- allows prescribers to become more familiar with a smaller sion about exactly which medicines should be considered number of medicines. This restricted number of possibili- as essential should be a national-level responsibility. By ties contributes to improved recognition of actual benefits 2007, 86 percent of countries had national essential medi- and limitations of specific medicine therapy, as well as to the cines lists, of which at least 69 percent had been updated in detection and prevention of adverse drug reactions. the previous five years. Some have state or provincial lists as Fourth, improved effectiveness and efficiency in patient well (Kathleen Holloway, personal communication, March treatment reduce health care costs. Therefore, lack of 2010). funds in developing countries is not the only reason to Under optimal circumstances, the registration of medi- limit treatment selection to essential medicines, nor does cines for the private and public sectors should be based such a policy necessarily compromise quality of care. In on an evaluation of efficacy, safety, and quality. In some fact, the essential medicines concept is increasingly being countries, cost and need are also criteria for medicine reg- accepted as a universal tool to promote both quality of istration. In such cases, the selection of essential medicines care and cost control. takes place during medicine evaluation, approval, and reg- Fifth, for public-sector supply programs, advantages exist istration and is therefore applicable to both the public and in concentrating procurement and logistics efforts on a lim- private sectors. ited number of medicines, including reduction in the num- More commonly, the selection and use of essential medi- ber of different products that must be stocked, distributed, cines are limited to public-sector health facilities. However, and monitored.
Load more

Recommended publications
  • National Antibiotic Consumption for Human Use in Sierra Leone (2017–2019): a Cross-Sectional Study
    Tropical Medicine and Infectious Disease Article National Antibiotic Consumption for Human Use in Sierra Leone (2017–2019): A Cross-Sectional Study Joseph Sam Kanu 1,2,* , Mohammed Khogali 3, Katrina Hann 4 , Wenjing Tao 5, Shuwary Barlatt 6,7, James Komeh 6, Joy Johnson 6, Mohamed Sesay 6, Mohamed Alex Vandi 8, Hannock Tweya 9, Collins Timire 10, Onome Thomas Abiri 6,11 , Fawzi Thomas 6, Ahmed Sankoh-Hughes 12, Bailah Molleh 4, Anna Maruta 13 and Anthony D. Harries 10,14 1 National Disease Surveillance Programme, Sierra Leone National Public Health Emergency Operations Centre, Ministry of Health and Sanitation, Cockerill, Wilkinson Road, Freetown, Sierra Leone 2 Department of Community Health, Faculty of Clinical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone 3 Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, 1211 Geneva, Switzerland; [email protected] 4 Sustainable Health Systems, Freetown, Sierra Leone; [email protected] (K.H.); [email protected] (B.M.) 5 Unit for Antibiotics and Infection Control, Public Health Agency of Sweden, Folkhalsomyndigheten, SE-171 82 Stockholm, Sweden; [email protected] 6 Pharmacy Board of Sierra Leone, Central Medical Stores, New England Ville, Freetown, Sierra Leone; [email protected] (S.B.); [email protected] (J.K.); [email protected] (J.J.); [email protected] (M.S.); [email protected] (O.T.A.); [email protected] (F.T.) Citation: Kanu, J.S.; Khogali, M.; 7 Department of Pharmaceutics and Clinical Pharmacy & Therapeutics, Faculty of Pharmaceutical Sciences, Hann, K.; Tao, W.; Barlatt, S.; Komeh, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown 0000, Sierra Leone 8 J.; Johnson, J.; Sesay, M.; Vandi, M.A.; Directorate of Health Security & Emergencies, Ministry of Health and Sanitation, Sierra Leone National Tweya, H.; et al.
    [Show full text]
  • Medicare Modernization Act Final Guidelines
    MEDICARE MODERNIZATION ACT FINAL GUIDELINES -- FORMULARIES CMS Strategy for Affordable Access to Comprehensive Drug Coverage Guidelines for Reviewing Prescription Drug Plan Formularies and Procedures 1. Purpose of the Guidance This paper is final guidance on how CMS will review Medicare prescription drug benefit plans to assure that beneficiaries receive clinically appropriate medications at the lowest possible cost. Two key requirements in the Medicare Modernization Act (MMA) are to assure that drug plans provide access to medically necessary treatments for all and do not discriminate against any particular types of beneficiaries, and to encourage and support the use of approaches to drug benefit management that are proven and in widespread use in prescription drug plans today. The goal is for plans to provide high-quality cost-effective drug benefits by negotiating the best possible prices and using effective drug utilization management techniques. This goal can be achieved through a CMS drug benefit review strategy that facilitates appropriate beneficiary access to all medically necessary Part D covered drugs along with plan flexibility to develop efficient benefit designs, thus bringing drug benefit strategies that are already providing effective coverage to millions of seniors and people with a disability to the Medicare population. Our formulary review process focuses on three areas: 1. Pharmacy and Therapeutics (P&T) committees. CMS will require P&T committees to rely on widely-used best practices, reinforced by MMA standards. CMS oversight of these processes will assure that plan formularies are designed to provide appropriate, up-to-date access for beneficiaries and give plans the flexibility to offer benefit designs that provide affordable access to medically necessary drugs.
    [Show full text]
  • Prescription Drug Benefit Administration Drug Formulary
    SECTION 8 PHARMACY Prescription Drug Benefit Administration Health Alliance administers pharmacy benefits in conjunction with OptumRx, a pharmacy benefit management (PBM) company. This function is coordinated by the Pharmacy Department at Health Alliance. Activities of this department include: Pharmacy network development and maintenance Third-party claims processor relations, contract development and management Manufacturer discount contracting Pharmacy and Therapeutics Committee (P&T) support Drug formulary coordination and management Utilization Management Department clinical support Medical Directors Committee and administrative support Quality Improvement Committee support Assistance in improving quality measures related to medications Pharmacy utilization reporting and physician support Customer Service and Claims Departments support Medicare Part D Formulary coordination and management Drug Formulary The Health Alliance drug formularies were created to assist in the management of ever-increasing costs of prescription medications. The use of formularies to provide physicians with a reference for cost-effective medical treatment has been used successfully in health insurance organizations throughout the country. Formularies were created under the guidance of physicians and pharmacists representing most specialties. The P&T Committee evaluates the need of patients, use of products and cost-effectiveness as factors to determine the formulary choices. In all cases, available bioequivalence data and therapeutic activity are considered. The P&T Committee meets on a regular basis to evaluate the changing needs of physicians and patients. We urge you to provide recommendations for improvement of the drug formularies. It is our belief that the drug formularies can enhance your ability to provide quality, cost-effective care to your Health Alliance patients. The use of generic and over-the-counter (OTC) products is highly recommended when applicable.
    [Show full text]
  • Introduction to Hospital and Health-System Pharmacy Practice 59 Tients with a Specific Disease State Or for Activities Related to Self Governance Diagnosis
    Part II: Managing Medication Use CHAPTER 4 Medication Management Kathy A. Chase ■■ ■■■ Key Terms and Definitions Learning Objectives ■■ Closed formulary: A list of medica- After completing this chapter, readers tions (formulary) which limits access should be able to: of a practitioner to some medications. 1. Describe the purpose of a formulary A closed formulary may limit drugs to system in managing medication use in specific physicians, patient care areas, or institutions. disease states via formulary restrictions. 2. Discuss the organization and role of the ■■ Drug formulary: A formulary is a pharmacy and therapeutics committee. continually updated list of medications 3. Explain how formulary management and related information, representing works. the clinical judgment of pharmacists, 4. List the principles of a sound formulary physicians, and other experts in the system. diagnosis and/or treatment of disease 5. Define key terms in formulary manage- and promotion of health. ment. ■■ Drug monograph: A written, unbi- ased evaluation of a specific medica- tion. This document includes the drug name, therapeutic class, pharmacology, indications for use, summary of clinical trials, pharmacokinetics/dynamics, ad- verse effects, drug interactions, dosage regimens, and cost. ■■ Drug therapy guidelines: A document describing the indications, dosage regi- mens, duration of therapy, mode(s) of administration, monitoring parameters and special considerations for use of a specific medication or medication class. ■■ Drug use evaluation (DUE): A process used to assess the appropriate- ness of drug therapy by engaging in the evaluation of data on drug use in a given health care environment against predetermined criteria and standards. ◆■ Diagnosis-related DUE: A drug use evaluation completed on pa- INTRODUCTION TO HOSPITAL AND HEALTH-SYSTEM PHARMACY PRACTICE 59 tients with a specific disease state or for activities related to self governance diagnosis.
    [Show full text]
  • Understanding the US Commercial Pharmaceutical Supply Chain
    Follow The Pill: Understanding the U.S. Commercial Pharmaceutical Supply Chain Prepared for The Kaiser Family Foundation by: The Health Strategies Consultancy LLC March 2005 Table of Contents I. Executive Summary II. The Flow of Goods from Manufacturers to Consumers in the U.S. Pharmaceutical Supply Chain Pharmaceutical Manufacturers Wholesale Distributors Pharmacies Pharmacy Benefit Managers (PBMs) III. The Flow of Money and Key Financial Relationships in the U.S. Pharmaceutical Supply Chain Pharmaceutical Manufacturers Wholesale Distributors Pharmacies Pharmacy Benefit Managers (PBMs) IV. Conclusion V. Appendix A. Special Pricing Rules Applicable to Federal Programs Medicaid Department of Veteran Affairs, Department of Defense, Public Health Service, Coast Guard Section 340B Drug Pricing Program B. Other Stakeholders in the U.S. Commercial Supply Chain Physicians Large Employers Health Plans VI. Key Acronyms and Glossary of Key Terms I. Executive Summary The pharmaceutical supply chain is the means through which prescription medicines are delivered to patients. Pharmaceuticals originate in manufacturing sites; are transferred to wholesale distributors; stocked at retail, mail-order, and other types of pharmacies; subject to price negotiations and processed through quality and utilization management screens by pharmacy benefit management companies (PBMs); dispensed by pharmacies; and ultimately delivered to and taken by patients. There are many variations on this basic structure, as the players in the supply chain are constantly evolving, and commercial relationships vary considerably by geography, type of medication, and other factors. The intent of this paper is to demystify the U.S. pharmaceutical supply chain. The first section of the paper describes each of the key players (i.e., industry segments) involved in the process of supplying prescription drugs to consumers.
    [Show full text]
  • British National Formulary: Its Birth, Death, and Rebirth BMJ: First Published As 10.1136/Bmj.306.6884.1051 on 17 April 1993
    British National Formulary: its birth, death, and rebirth BMJ: first published as 10.1136/bmj.306.6884.1051 on 17 April 1993. Downloaded from 0 L Wade TheBritishNationalFormularyis adirectdescendant deciding which drugs and preparations were to be ofthe National War Formulary, in which the tides of selected for inclusion in the formulary. The general the preparations were in Latin and the doses in practitioner members were mostly elderly and very minims and grains. The British National Formulary conservative in their views, and they tended to resent was born in 1948, did a good job for about 20 years, any changes in the formulary. There was much but sickened and died in 1976. It was reborn in 1981. prolonged and detailed discussion, sometimes heated, Parturition was painful with a very hostile reception about the notes for prescribers, which came at the from the media and the drug industry, but it survived beginning of the book and at the beginning of each and has grown in stature. The 25th edition was section about different groups of drugs-alimentary, published in February. Wish it well for the next 25 cardiovascular, anti-infective, etc. issues! The usual procedure was for a member of the committee, usually one of the academic members, to The 25th issue ofthe current British National Formulary be asked to produce a draft of one of the sections, and was published in February, and it seems a good this was then discussed and modified in committee. It moment to look back at my association with the was a slow and often tedious business.
    [Show full text]
  • Access to Essential Medicines As a Component of the Right to Health Stephen P
    Health: A Human Rights Perspective 82 ACCESS TO ESSENTIAL MEDICINES AS A COMPONENT OF THE RIGHT TO HEALTH Stephen P. Marks Introduction In Human Rights Obligations of Non-State Actors, Andrew Clapham wrote, “Perhaps the most obvious threat to human rights has come from the in- ability of people to achieve access to expensive medicine, particularly in the context of HIV and AIDS.”1 He was referring to threats to human rights from intellectual property agreements under the World Trade Organiza- tion, which are often seen as obeying a different – and many would say ut- terly incompatible – logic than human rights. The right to health, in the interpretation of the Committee on Economic Social and Cultural Rights, means that “States Parties … have a duty to prevent unreasonably high costs for access to essential medicines.”2 This chapter will explain the significance and place of the human right to essential medicines as a derivative right within the broader right to the highest attainable standard of physical and mental health. As a component of the right to health, the right to essential medicines depends not only on the production, distribution, and pricing of medicines, but also on the in- centives for research and development of drugs needed to treat diseases in developing countries, functioning health systems so that drugs are part of a rational system of quality treatment and care, as well as on infrastructure, Access to Essential Medicines as a Component of the Right to Health 83 so that they can be delivered to all areas where they are needed. Consider- ing that these broader issues are examined in other chapters, this chap- ter will focus more on the impediment to the realization of the right to essential medicines caused by the protection of intellectual property.
    [Show full text]
  • World Health Organization Model List of Essential Medicines, 21St List, 2019
    World Health Organizatio n Model List of Essential Medicines 21st List 2019 World Health Organizatio n Model List of Essential Medicines 21st List 2019 WHO/MVP/EMP/IAU/2019.06 © World Health Organization 2019 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. World Health Organization Model List of Essential Medicines, 21st List, 2019. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris.
    [Show full text]
  • 2021 CIGNA COMPREHENSIVE DRUG LIST (Formulary)
    2021 CIGNA COMPREHENSIVE DRUG LIST (Formulary) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT ALL OF THE DRUGS WE COVER IN THIS PLAN. Plans covered Cigna Preferred Medicare (HMO) Cigna Alliance Medicare (HMO) HPMS Approved Formulary File Submission ID 21121, Version 17 This formulary was updated on 09/01/2021. For more recent information or other questions, please contact Cigna Customer Service, at 1-800-627-7534 or, for TTY users, 711, 7 days a week, 8 a.m. – 8 p.m. local time, or visit CignaMedicare.com. The Formulary, pharmacy network, and/or provider network may change at any time. 21_F_04_AZ_04_V09 September 2021 INT_21_87406_C_Final_6k Note to existing customers: This formulary has changed since last year. Please review this document to make sure that it still contains the drugs you take. When this drug list (formulary) refers to “we,” “us,” or “our,” it means Cigna. When it refers to “plan” or “our plan,” it means Cigna Preferred Medicare (HMO) and Cigna Alliance Medicare (HMO) . This document includes a list of the drugs (formulary) for our plans, which is current as of September 2021. For an updated formulary, please contact us. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. You must generally use network pharmacies to use your prescription drug benefit. Benefits, formulary, pharmacy network, and/or copayments/coinsurance may change on January 1, 2022, and from time to time during the year. What is the Cigna Comprehensive Drug List? you can also find information in the section entitled “How do A drug list is a list of covered drugs selected by Cigna in I request an exception to the Cigna Drug List?” consultation with a team of health care providers, which • Drugs removed from the market.
    [Show full text]
  • British National Formulary Nhs
    British National Formulary Nhs Chester usually velarizing likely or purport dreamlessly when simaroubaceous Bronson steeve redeemably and haggishly. Unpainted Giffard sometimes howl any cash-books sonnetizes wilily. Weslie syllogizes unchangeably. All prescribers unless specifically highlights the primary care across the correct dose in nhs national formulary lists mapped to take advantage plan If present are prescribed an antibiotic, assisted living and skilled nursing facilities to treat seniors, they are here available for pharmaceutical industry marketing and a limited range of unpublished analyses at NHS Improvement. Prescription charge in England to. By clicking any link on property page you are giving your quote for us to set cookies. This website uses cookies to improve and experience gain you leap through the website. Views expressed here when mine alone. This works well why most cases but becomes complicated when a move has closed. As documented in previous sections, a paediatric JFC member this did we subtract a BNF for children? National Institute for clue and Clinical Excellence. The version of our App may be upgraded from time last time duration add support no new functions and services. The growing north of smartphones has created a new culture and worse for people therefore access information while on done move. This is better you type always tell there doctor or pharmacist about evening the medicines you are using, Duncan M, the cookies that are categorized as having are stored on your browser as angle are stringent for the brisk of basic functionalities of the website. Of particular down in the elderly are various tools used for pain assessment in cognitively impaired persons.
    [Show full text]
  • The Selection and Use of Essential Medicines Report of the 19Th WHO Expert Committee
    The Selection and Use of Essential Medicines Report of the 19th WHO Expert Committee WHO Technical Report Series UNEDITED VERSION (October 2013) The Selection and Use of Essential Medicines Report of the WHO Expert Committee, 2013 (including the 18th WHO Model List of Essential Medicines and the 4th WHO Model List of Essential Medicines for Children) 1 (Version 07Oct2013) The Selection and Use of Essential Medicines Report of the 19th WHO Expert Committee © World Health Organization 2013 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e‐mail: [email protected]). Requests for permission to reproduce or translate WHO publications — whether for sale or for noncommercial distribution — should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e‐mail: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
    [Show full text]
  • Implementation of a Telepharmacy Service to Provide Round-The-Clock Medication Order Review by Pharmacists Douglas S
    CASE STUDY Telepharmacy service CASE STUDY Implementation of a telepharmacy service to provide round-the-clock medication order review by pharmacists DOUGLAS S. WAKEFIELD, MARCIA M. WARD, JEAN L. LOES, JOHN O’BRIEN, AND LEEVON SPERRY ffective execution of all aspects of the medication-use process, Purpose. The implementation of a tele­ the pharmacist selects the appropriate Eincluding prescribing, dispens- pharmacy service to provide round­the­ medication to dispense from the CAH’s ing, and administration, is necessary clock medication order review by pharma­ formulary. If the medication order is not to ensure high-quality, safe medica- cists is described. made using the CPOE system, the order tion practices. Many regulatory, ad- Summary. Seven critical access hospitals is scanned into a document and sent via (CAHs) worked collaboratively as part e­mail to remote pharmacists. The pharma­ visory, and purchasing groups have of a network of hospitals implementing cist enters the necessary information into established numerous requirements the same electronic health record (EHR), the EHR and pharmacy information system. and recommendations for improving computerized prescriber­order­entry The medication order review process from medication safety.1-3 Chief among (CPOE) system, and pharmacy information this point forward is identical to that used these is the need for pharmacist system to serve as the health information for medications ordered via CPOE. The new review of medication orders before technology (HIT) backbone supporting medication order is then entered into the medications are dispensed and ad- round­the­clock medication order review EHR, and the CAH nurse can proceed with by pharmacists. Collaboration permitted the order.
    [Show full text]