HP Newsletter - Hospice Pharmacia

8
Passionate for the Appropriate Use of Medication
“Proven and Safer...”
continued from page 1
“I forgot my PIN!”
- Mark Schreiber, Technical Support
Manager
We are delighted that more than 80%
of our hospice clients are participating
in the PIN (Personal Identification
Number) program. The purpose of the
PIN program is to comply with HIPAA’s
Privacy Rule.
Just a reminder: Even if a hospice team
member does not use Xeris, he or she
still needs a Xeris account in order to
obtain a PIN number, as we establish
and keep record of nurse profiles in
Xeris. Every HP hospice has selected
a Xeris Hospice Administrator (XHA)
who serves as the Xeris security liaison
between the hospice and HP. The XHA
is authorized to create Xeris accounts
and reset Xeris passwords. Since PIN
is managed through Xeris, your XHA is
authorized to reset your PIN, should you
forget it what it is.
You may also consult the Xeris Reference
Manual with questions. An updated
version of this manual may be found
on the Xeris Welcome Page in the “HP
Announcements” section.
Your Regional Director of Client
Development (RDCD) is available to
assist with any of the above steps. If you
have any further questions regarding
PIN, please contact your RDCD, or email
HPPartners@excelleRx.com. If you are
an XHA and require technical assistance,
feel free to contact our Technical Support
team at support@excellerx.com.
• Insomnia: A statistically significant
number of patients receiving temazepam
(a first line therapy for insomnia in the
MUGs) achieved a complete response as
compared with zolpidem (52% vs. 22%,
p < 0.05).
- This finding suggests that HP’s first
line therapy of temazepam is more
effective in treating insomnia than
zolpidem, a common medication
that is used outside of the insomnia
protocol.
• Nausea: A statistically significant
proportion of patients receiving
prochlorperazine (HP’s first line therapy
for nausea) achieved a complete response
as compared to patients taking oral
ondansetron, an expensive alternative
commonly prescribed in the oncology
community (48.9% vs. 26.7%; p < 0.05).
The study also found a striking difference
between patient groups that experienced
worsened nausea control after initiating
therapy (8.9% for prochlorperazine vs.
26.7% for ondansetron, p < 0.05).
- This finding suggests that
ondansetron is not superior to
prochlorperazine, in treating
nausea that is secondary to an
unknown etiology (e.g. not receiving
chemotherapy or radiation).
We launched the aforementioned study
to test the hypothesis that HP’s evidencebased
Medication Use Guidelines are
associated with better hospice and patientrelated
outcomes. Our findings suggest
that evidence-based prescribing using the
MUGs produces better patient outcomes
when compared to “preference-based”
prescribing.
In addition, while this study was not
constructed to analyze the cost-effectiveness
of the symptom management medications
selected for analysis, it is noteworthy that
HP’s first-line therapies in this study are
less costly than the non-MUG medications
to which they were compared.
These findings support the application of
the MUGs as evidence-based guidelines
that both improve symptom management
and assure cost-appropriate medication
selection for hospice patients, especially
when applied under the prescriberdirected,
pharmacist-driven Collaborative
Practice model.
The bottom line: When the right medication
is selected the first time and the patient is
monitored for therapeutic and potential or
actual adverse effects, patients are not just
more comfortable, they experience greater
safety from untoward adverse medication
outcomes. “Proven and safer”—goals that
should concern every one of us—are within
reach and available to our health care
system’s frailest patients including those
who are receiving hospice care as they
approach the end of life.
1
Leape, L.L. , and Berwick, D.M. (2005). Five years
after To Err is Human: What have we learned? JAMA,
293 (19), 2384-2390.
2
Kohn, K.T., Corrigan, J.M., & Donaldson, M.
(1999). To err is human: Building a safer health care
system. Washington, DC: National Academy Press.
excelleRx Newsletter Staff
Editor In Chief:
Orsula Voltis, PharmD, MBA
Chief Marketing Officer
orsula@excelleRx.com
Managing Editor:
Dana Filippoli
Senior Director of Marketing
dfilippoli@excelleRx.com
Layout and Design:
Melissa Morris
Graphic Designer
www.hospicepharmacia.com