Impact of an innovative blood factor stewardship program on drug expense and patient care

American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
Lindsey B AmerineScott W Savage

Abstract

An innovative pharmacist-led program to improve prescribing, dosing, and monitoring of clotting factor therapy within a large health system is described. In an initiative to optimize patient outcomes and control costs associated with the use of clotting factor concentrates, the pharmacy department at University of North Carolina Medical Center (UNCMC) led the development of a "factor stewardship program" in collaboration with UNCMC hematologists. Key steps in program development and implementation included (1) selection of one formulary product within each clotting factor class, (2) establishment of guidelines on blood factor prescribing, order review, compounding, and administration, and (3) initial and ongoing education of pharmacy, nursing, and medical staff. As part of the program, a designated pharmacist rounds with hematologists daily, recommending treatment plan modifications and dosage adjustments as appropriate. Now in its fifth year, the stewardship program has enabled consistent pharmacist oversight of all aspects of clotting factor use and enhanced transitions-of-care coordination. Through optimization of product selection, dosing regimens, and infusion frequencies, the number of blood factor doses in fiscal year 20...Continue Reading

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Citations

Apr 14, 2016·Expert Review of Pharmacoeconomics & Outcomes Research·Alessandro GringeriArmin J Reininger
Sep 8, 2016·Hospital Pediatrics·Amir ElmekkawiRobert P Jankov
Mar 25, 2018·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Dan SchenkatScott Knoer
Jul 11, 2019·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Eve M SegalKate D Jeffers
Sep 23, 2020·Blood Advances·Jori E MayNathan T Connell
Jul 30, 2020·Pharmacy : Journal of Pharmacy, Education and Practice·Lisa M HolleKate D Jeffers
May 12, 2019·Neurocritical Care·Sarah L ClarkAndrea P Tully
Feb 29, 2020·Journal of Thrombosis and Thrombolysis·Anem WaheedRaymond L Comenzo
Nov 24, 2016·Journal of Thrombosis and Thrombolysis·Maura K WychowskiRonald L Sham

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