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Leveraging an Outpatient Pharmacy to Reduce Medication Waste in Pediatric Asthma Hospitalizations

Hoefgen, Erik R
http://orcid.org/0000-0002-6630-538X
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1583998769748808

Abstract Details

2020, MS, University of Cincinnati, Medicine: Clinical and Translational Research.
Background & Objective: Previous local quality improvement focused on discharging patients with inhaled corticosteroids (ICS) “in-hand” decreased healthcare reutilization after hospitalization for an asthma exacerbation. However, as a result of these new processes, some patients admitted for an asthma exacerbation received more than one ICS inhaler during their admission, contributing to medication waste and potential patient confusion regarding their discharge medication regimen. We sought to decrease this waste. Methods: We conducted a quality improvement project to reduce prescribing of multiple ICS inhalers to patients at a large academic children’s hospital. Our primary outcome measure was the monthly percentage of patients admitted for an asthma exacerbation administered more than one ICS inhaler. A secondary outcome measure evaluated the reliability of the new process of using the hospital-based outpatient pharmacy to supply ICS “in-hand” and verify insurance coverage. After process map review, we hypothesized a delay in the initial ICS treatment decision would allow for both a finalized discharge medication plan and a standardized process to verify outpatient insurance coverage. Results: The mean percent of patients receiving more than one ICS inhaler decreased from our baseline of 7.4% to 0.7%. Verification of outpatient prescription insurance coverage via the outpatient pharmacy increased from 0.7% to 50%. The average inpatient cost (average wholesale price) for ICS decreased 62% to $90.25. Conclusions: Our process change to use the outpatient pharmacy to dispense and to verify insurance coverage for ICS medication was associated with reduction in medication waste during admission for an asthma exacerbation.
Aimin Chen, Ph.D. (Committee Chair)
Katherine Auger (Committee Member)
Bin Huang (Committee Member)
19 p.
Surgery
Quality Improvement; Asthma; Pediatrics; Outpatient pharmacy; high value care

Recommended Citations

Citations

  • Hoefgen, E. R. (2020). Leveraging an Outpatient Pharmacy to Reduce Medication Waste in Pediatric Asthma Hospitalizations [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1583998769748808

    APA Style (7th edition)

  • Hoefgen, Erik. Leveraging an Outpatient Pharmacy to Reduce Medication Waste in Pediatric Asthma Hospitalizations. 2020. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1583998769748808.

    MLA Style (8th edition)

  • Hoefgen, Erik. "Leveraging an Outpatient Pharmacy to Reduce Medication Waste in Pediatric Asthma Hospitalizations." Master's thesis, University of Cincinnati, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1583998769748808

    Chicago Manual of Style (17th edition)

ucin1583998769748808
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© 2019, all rights reserved.
This open access ETD is published by University of Cincinnati and OhioLINK.