Suarez F, McLeod K, Pepin L
… +2 more, Schuenke D, Hoyte C
Am J Health Syst Pharm
· 2026 Feb · PMID 41677370
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PURPOSE: Acute cocaine intoxication remains a common emergency department presentation, with well-described symptoms including agitation, tachycardia, hypertension, and hyperthermia. Cocaine also has sodium channel antag...PURPOSE: Acute cocaine intoxication remains a common emergency department presentation, with well-described symptoms including agitation, tachycardia, hypertension, and hyperthermia. Cocaine also has sodium channel antagonist properties, resulting in QRS interval prolongation and ventricular dysrhythmias. Cocaine-induced QRS interval prolongation is typically treated with 8.4% sodium bicarbonate to increase the concentration of sodium at sodium channels and increase pH, thereby decreasing the amount of free drug binding to sodium channels. However, drug shortages, including recent shortages of sodium bicarbonate, have prompted the use of alternative therapies to treat drug toxicities typically treated with sodium bicarbonate. SUMMARY: We report the case of a 44-year-old male with a history of cocaine use who presented to the emergency department in cardiac arrest with presumed cocaine toxicity. Because of QRS complex widening noted on telemetry, 3 boluses of sodium bicarbonate were administered but only reduced the duration of the QRS interval from 165 to 130 ms with laboratory evidence of acidemia. To help treat the patient's significant acidemia, 500 mL of 36 mg/mL tromethamine (THAM) was administered over 60 minutes. While THAM is not typically used in the treatment of toxicity due to sodium channel antagonism, it has been used in the treatment of metabolic acidosis in the intensive care unit, acting as a buffer by directly accepting protons. Approximately 35 minutes after administration of THAM, the duration of the QRS complex had decreased to 111 ms and venous blood gas analysis showed an improvement in the pH to the normal range. Following THAM administration, the patient's QRS duration remained below 120 ms for the remainder of their hospitalization. CONCLUSION: This case illustrates the successful use of THAM in conjunction with sodium bicarbonate for the treatment of severe acidemia and refractory QRS complex widening in presumed cocaine toxicity. While sodium bicarbonate remains the mainstay of therapy for sodium channel blocker toxicity, THAM offers a potentially valuable adjunctive treatment, especially in the context of drug shortages.
Loubet P, Chandak A, Spivey S
… +5 more, Doi Y, Amin AN, Ahuja N, Müller V, Sax PE
Am J Health Syst Pharm
· 2026 Apr · PMID 41672739
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PURPOSE: The aim of this study was to evaluate the effectiveness of remdesivir among vulnerable patients hospitalized with a primary diagnosis of coronavirus disease 2019 (COVID-19). METHODS: In this retrospective study,...PURPOSE: The aim of this study was to evaluate the effectiveness of remdesivir among vulnerable patients hospitalized with a primary diagnosis of coronavirus disease 2019 (COVID-19). METHODS: In this retrospective study, data from the Premier Healthcare Database compiled from December 2021 to December 2024 were examined. Four cohorts were analyzed: overall (≥18 years of age), elderly (≥65 years of age), those with pneumonia due to COVID-19, and those with chronic obstructive pulmonary disease (COPD). Analyses were stratified by supplemental oxygen requirements upon admission. Patients treated with remdesivir within the first 2 days of hospitalization were matched to those not treated with remdesivir during hospitalization, using 1:1 propensity score matching without replacement. Outcomes of interest were 14- and 28-day all-cause inpatient mortality. RESULTS: A total of 220,677 patients met the eligibility criteria; of these, 123,388 (55.9%) were treated with remdesivir within the first 2 days of hospitalization. Overall, treatment with remdesivir was associated with significantly lower 14- and 28-day mortality rates compared to rates in patients who did not receive remdesivir (adjusted hazard ratio [95% CI], 0.76 [0.73-0.79] and 0.78 [0.75-0.81], respectively; P < 0.0001). Similar results were observed across all patient groups irrespective of supplemental oxygen requirements and across early (December 2021-December 2022) and later (January 2023-December 2024) Omicron periods. CONCLUSIONS: These results build on previous research highlighting the effectiveness of early treatment initiation with remdesivir in vulnerable patients hospitalized due to SARS-CoV-2 infection.
Kalil AC, Yaghoubi M, Ahuja N
… +4 more, Kadambi A, Oppelt T, Rivera CG, Kuritzkes DR
Am J Health Syst Pharm
· 2026 Apr · PMID 41671406
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PURPOSE: SARS-CoV-2 infection continues to impact global health, particularly among high-risk vulnerable individuals. With the loss of federal funding for SARS-CoV-2 management, hospitals will need to budget appropriatel...PURPOSE: SARS-CoV-2 infection continues to impact global health, particularly among high-risk vulnerable individuals. With the loss of federal funding for SARS-CoV-2 management, hospitals will need to budget appropriately for antivirals like remdesivir, which has demonstrated effectiveness in reducing mortality. We evaluated the economic impact realized by hospitals for patients hospitalized for SARS-CoV-2 infection and initiated on remdesivir therapy. METHODS: We conducted a retrospective analysis using data compiled in the Premier Healthcare Database from January 2023 to February 2024. Propensity score matching was used to compare remdesivir-treated (RDV) and untreated (No RDV) groups. The mortality rate, hazard ratios associated with remdesivir use, and hospitalization costs were assessed overall and among the elderly (age ≥65 years). We also conducted a cost-effectiveness analysis to assess the economic value of remdesivir treatment. RESULTS: Among 25,498 hospitalized patients, the mortality rate in the RDV group was lower than in the No RDV group (6.2% versus 8.1%), with a greater reduction in the elderly (6.9% versus 9.0%). Remdesivir significantly reduced mortality risk by approximately 25% overall and among the elderly. Each life saved was realized at a minimal increase in average hospitalization costs ($18,329 in the RDV group versus $14,845 in the No RDV group). Remdesivir was a cost-effective treatment option at a willingness-to-pay threshold of $25,000 overall and among the elderly. CONCLUSIONS: Our evaluation provides contemporaneous evidence of benefits and costs associated with management of individuals hospitalized for SARS-CoV-2 infection. Initiation of remdesivir was associated with minimal incremental hospitalization costs for lives saved as compared to not initiating remdesivir. Hospital pharmacy leadership can utilize this real-world evidence to appropriately budget for remdesivir treatment.
Kalil AC, Chima-Melton C, Naslazi E
… +4 more, Ramroth H, Amin AN, Pettit NN, Gottlieb RL
Am J Health Syst Pharm
· 2026 Apr · PMID 41664408
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PURPOSE: Immunocompromised adults hospitalized for coronavirus disease 2019 (COVID-19) remain at high risk for morbidity. Despite remdesivir's approval for treatment of COVID-19, real-world evidence on its early use, par...PURPOSE: Immunocompromised adults hospitalized for coronavirus disease 2019 (COVID-19) remain at high risk for morbidity. Despite remdesivir's approval for treatment of COVID-19, real-world evidence on its early use, particularly in patients infected with evolving Omicron-era subvariants, remains limited. Contemporary evidence is essential to support hospital pharmacy practice and antiviral stewardship. METHODS: We conducted a retrospective cohort study using the Premier Healthcare Database. Adult immunocompromised patients hospitalized for COVID-19 from December 2021 to December 2024 were included. Patients with COVID-19 present-on-admission who received remdesivir within the first 2 hospital days were compared to untreated patients using 1:1 propensity score matching. The outcomes assessed were 14- and 28-day all-cause mortality. Subgroup analyses assessed outcomes stratified by oxygen requirements and specific immunocompromising conditions. RESULTS: Among 22,808 matched patients, early remdesivir use was associated with significantly lower 14-day (hazard ratio [HR], 0.75; 95% CI, 0.69-0.82; P < 0.0001) and 28-day mortality (HR, 0.80; 95% CI, 0.74-0.86; P < 0.0001). Mortality reductions were observed across early and later Omicron periods and among patients with or without supplemental oxygen requirements. Subgroup analyses showed similar survival benefit in patients with cancer, including hematologic malignancies, as well as transplant recipients. CONCLUSIONS: Early remdesivir initiation was associated with clinically meaningful and significant survival benefits in immunocompromised patients hospitalized for COVID-19, with these associations persisting in the Omicron subvariant era. These findings highlight the potential benefit of early antiviral treatment in this vulnerable population while underscoring the need for further prospective studies, including randomized controlled trials, to confirm causal effects and refine treatment strategies. Clinical pharmacists have a pivotal role in ensuring institutional protocols remain aligned with current evidence so that eligible high-risk patients consistently receive appropriate therapy.
Amin AN, Oppelt T, Chandak A
… +4 more, Gottlieb RL, Chima-Melton C, Pettit NN, Kalil AC
Am J Health Syst Pharm
· 2026 Apr · PMID 41662382
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PURPOSE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to pose a risk to vulnerable populations. This retrospective study compared the effectiveness of remdesivir plus corticosteroids (CCS) versu...PURPOSE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to pose a risk to vulnerable populations. This retrospective study compared the effectiveness of remdesivir plus corticosteroids (CCS) versus CCS alone in patients hospitalized with COVID-19 from December 2021 to December 2024. METHODS: Data were extracted from a large, geographically-diverse US Premier Healthcare Database for adults hospitalized for COVID-19. Exclusion criteria included pregnancy, incomplete data, transfer from another hospital or hospice care, death/discharge during the baseline period, elective procedure admissions, patients without supplemental oxygen in hospitals that did not report charges for low-flow oxygen, and patients on extracorporeal membrane oxygenation. Propensity score matching was used to balance the distribution of underlying confounders in the two treatment groups. A Cox proportional hazards model was used to assess time to 14- and 28-day inpatient all-cause mortality. RESULTS: A total of 104,900 patients were initiated on remdesivir plus CCS and 66,016 were initiated on CCS alone in the first 2 days of hospitalization. Unadjusted 14- and 28-day mortality rates were lower for remdesivir-treated patients versus patients who did not receive remdesivir during hospitalization. Remdesivir plus CCS initiation upon admission for COVID-19 (in the total population) was associated with a significantly lower mortality rate (P < 0.0001) (in the overall Omicron period) at both 14 and 28 days, with an adjusted hazard ratio (95% confidence interval) of 0.77 (0.74-0.80) and 0.79 (0.77-0.82), respectively, versus CCS alone. Results were similar for the total population in the early and later Omicron periods. CONCLUSION: Remdesivir plus CCS was associated with a significant reduction in inpatient all-cause mortality relative to CCS alone in patients hospitalized for COVID-19 across 3 years of the Omicron period, illustrating the utility of the most recent real-world evidence to help inform treatment recommendations for inpatient providers treating patients with SARS-CoV-2 infection.
Rivera CG, Mozaffari E, Read SH
… +1 more, Kalil AC
Am J Health Syst Pharm
· 2026 Apr · PMID 41656514
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PURPOSE: While randomized controlled trials remain the gold standard for assessing treatment efficacy, studies using real-world data (RWD) offer valuable insights into treatment effectiveness across broader, more diverse...PURPOSE: While randomized controlled trials remain the gold standard for assessing treatment efficacy, studies using real-world data (RWD) offer valuable insights into treatment effectiveness across broader, more diverse patient populations. This commentary explores the importance of using fit-for-purpose data and emphasizes the need for rigorous evaluation of RWD quality to support valid and actionable evidence generation. SUMMARY: The utility of RWD-based studies depends heavily on the fitness-for-purpose of the data source, which requires careful assessment of 5 key quality dimensions: relevance, extensiveness, timeliness, coherence, and reliability. Practical examples from coronavirus disease 2019 (COVID-19) comparative effectiveness research are used to illustrate each data quality domain. CONCLUSIONS: As the need for RWD increases, especially for post-COVID-19 pandemic decision-making, ensuring high data quality and appropriate study design is critical. Proper evaluation of RWD sources enhances the credibility of findings and supports their use in meta-analyses, clinical guidelines, and healthcare policy.
Shah SB, Lajthia E, Babin S
… +2 more, Deering KL, Patel AA
Am J Health Syst Pharm
· 2026 Jun · PMID 41636278
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PURPOSE: Recent advances in medication therapies for inflammatory bowel disease (IBD), including biologics and targeted small molecules, have been demonstrated to significantly improve patient outcomes; however, they hav...PURPOSE: Recent advances in medication therapies for inflammatory bowel disease (IBD), including biologics and targeted small molecules, have been demonstrated to significantly improve patient outcomes; however, they have also increased the complexity of care of patients with IBD. The objective of this report is to describe an integrated clinician and specialty pharmacy service model in IBD care to inspire other health systems to adopt similar approaches that could enhance patient care. SUMMARY: Multidisciplinary and integrated models of care for patients with IBD have been shown to improve patient outcomes and enhance quality of care. Specifically, pharmacists have demonstrated their ability to provide patient education, prevent interruptions to IBD therapy, improve medication adherence, and improve medication access. Ochsner Health System has developed a system for integrated pharmacy services with the Ochsner specialty pharmacy (OSP) and the Ochsner IBD clinic-based pharmacists. The OSP and IBD clinic-based pharmacists provide comprehensive services to patients with IBD, including medication evaluation for clinical appropriateness, patient education, benefits investigation and financial assistance, and appropriate monitoring of therapy once treatment is started. These services have demonstrated high rates of medication adherence, with the average proportion of days covered at 84.6%, and have expanded patient services within the IBD clinic. CONCLUSION: Integrated pharmacy services enhance patient care by improving therapy access, adherence, and monitoring. With the continued growth of specialty medications, adoption of integrated clinic pharmacy practice models and specialty pharmacies should be prioritized by health systems, clinics, and payers. These approaches cultivate multidisciplinary patient care and address the complex needs of individuals with IBD.
Am J Health Syst Pharm
· 2026 Feb · PMID 41635227
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PURPOSE: Reduced-dose apixaban or rivaroxaban has been suggested for extended-phase anticoagulant therapy for prevention of venous thromboembolism (VTE). The uptake of this suggestion in clinical practice is unclear. The...PURPOSE: Reduced-dose apixaban or rivaroxaban has been suggested for extended-phase anticoagulant therapy for prevention of venous thromboembolism (VTE). The uptake of this suggestion in clinical practice is unclear. The purpose of this study was to describe the prescribing patterns of apixaban and rivaroxaban for extended-phase anticoagulant therapy in an urban university setting. METHODS: This was a retrospective, single-center, observational study in patients 18 years of age or older with a history of VTE that occurred at least 6 months prior. Patients prescribed rivaroxaban or apixaban from December 2, 2021, until June 1, 2022, were included. Pregnant women and patients on apixaban or rivaroxaban for indications other than VTE were excluded. The primary outcome was the proportion of patients on reduced-dose vs full-dose apixaban or rivaroxaban. The secondary outcome was the presence of patient-specific characteristics that were more common in patients on reduced-dose vs full-dose anticoagulant. RESULTS: Of the 287 patients who met the eligibility criteria, 214 (74.6%) were prescribed full-dose apixaban or rivaroxaban and 73 (25.4%) were prescribed reduced-dose apixaban or rivaroxaban. Sickle cell disease was more common in patients prescribed full-dose anticoagulant (14.5% vs 2.7%; P = 0.01), and stage 5 chronic kidney disease was more common in patients prescribed reduced-dose anticoagulant (3.3% vs 11%; P = 0.01). Prescribers specialized in hematology/oncology were more likely to prescribe reduced-dose than full-dose anticoagulant (37.0% vs 22.4% of all prescriptions; P = 0.01). CONCLUSION: The majority of patients were prescribed full-dose rivaroxaban or apixaban for extended-phase anticoagulation, despite guidance suggesting use of a reduced dose. Prescribers may consider patient-specific risks for thrombosis and bleeding when selecting a dose of apixaban or rivaroxaban for VTE prevention.
MacKinnon T, Pounders K, Dienerc K
… +1 more, Doellner C
Am J Health Syst Pharm
· 2026 Feb · PMID 41634933
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PURPOSE: Peripheral intravenous infiltration and extravasation injuries (PIVIEs) in pediatric patients are a significant yet underrecognized source of preventable harm, often due to inconsistent detection and limited sta...PURPOSE: Peripheral intravenous infiltration and extravasation injuries (PIVIEs) in pediatric patients are a significant yet underrecognized source of preventable harm, often due to inconsistent detection and limited standardization. This study implemented a structured quality improvement initiative to enhance early detection, classification, and management of PIVIEs at C.S. Mott Children's Hospital, supporting the institution's goal of zero preventable harm. SUMMARY: This single-center, prospective quality improvement study was conducted at a 347-bed academic pediatric hospital from January 2023 to December 2024. All patients with a documented PIVIE were included. Key interventions included creation of a multidisciplinary PIVIE Prevention Task Force, standardized event review, development of a pediatric infusion agent risk classification algorithm, and updated antidote protocols. Outcomes measured included PIVIE reporting volume, antidote timeliness, and classification documentation. Descriptive statistics were used to assess trends. Following intervention, 628 PIVIEs were reported-a 465.8% increase from 111 events reported during the 2021-2022 period. Implementation of an institutional standard of care form and a centralized database improved documentation and expedited antidote administration. A pediatric-specific classification system was developed and applied to over 90 high-use agents, enabling risk-based clinical decision-making. CONCLUSION: Interdisciplinary, structured interventions markedly improved reporting, documentation, and treatment of pediatric PIVIEs. Adoption of standardized classification tools and review processes may help hospitals reduce IV-related complications. Policymakers and accrediting bodies should consider incentivizing pediatric vascular safety metrics, supporting integration of pediatric-specific risk frameworks, and encouraging cross-institutional data sharing to drive broader improvements in care.
Am J Health Syst Pharm
· 2026 Feb · PMID 41631701
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PURPOSE: Anticoagulants are one of the leading causes of adverse drug event-related emergency department (ED) visits and emergent hospitalizations, and high rates of inappropriate prescribing practices may be contributin...PURPOSE: Anticoagulants are one of the leading causes of adverse drug event-related emergency department (ED) visits and emergent hospitalizations, and high rates of inappropriate prescribing practices may be contributing. Nebraska Medicine implemented a direct oral anticoagulant (DOAC) indication-based prescribing panel on March 14, 2022. The goal of the panel is to assist with agent selection, dosing, and monitoring while ensuring indications and quantities are defaulted correctly. The purpose of this study was to assess the impact of an indication-based DOAC panel on appropriate prescribing in the ED. METHODS: This retrospective chart review included adult patients discharged from the ED with a new DOAC prescription before and after implementation of an indication-based prescribing panel from January 1, 2020, to March 13, 2022, and from July 1, 2022, to September 14, 2023, respectively. Data were analyzed using descriptive statistics, χ2 tests, and Student's t tests. RESULTS: A total of 200 patients were included in the final analysis, with 100 in each group. The primary outcome of inappropriate prescriptions occurred in 18% of patients in the pre-panel group and 7% of patients in the post-panel group (P = 0.020). The difference in the proportion of prescriptions requiring pharmacist involvement between the pre- and post-panel groups was statistically significant at 31% vs 17%, respectively (P = 0.020). There was no difference between the groups in the rate of return to the ED within 30 days for any indication. CONCLUSION: Implementation of an indication-based prescribing panel for DOACs led to a decrease in inappropriate prescribing of DOACs in the ED. Use of the panel decreased the need for pharmacist intervention and resources.
Am J Health Syst Pharm
· 2026 Feb · PMID 41628903
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PURPOSE: A novel value assessment framework (VAF) for evaluating oncology and nononcology medications for formulary addition was developed and validated at UT Southwestern Medical Center (UTSW). METHODS: The novel VAF wa...PURPOSE: A novel value assessment framework (VAF) for evaluating oncology and nononcology medications for formulary addition was developed and validated at UT Southwestern Medical Center (UTSW). METHODS: The novel VAF was developed based on literature examples while incorporating UTSW institutional priorities in the formulary decision process. Six criteria were selected to be evaluated in the VAF: efficacy, safety/tolerability, novelty/unmet need, quality of evidence, cost (by administration site), and operational logistics. The study included a retrospective review of the monographs of medications considered for formulary addition between October 2021 and October 2024, with scores evaluated for inter-rater reliability via the intraclass correlation coefficient (ICC) among 3 reviewers. Monographs for diagnostic or nontherapeutic targeted agents, drug class reviews, and otherwise incomplete monographs were excluded from the study. RESULTS: The novel UTSW VAF was determined to have good inter-rater reliability overall among the 3 reviewers (ICC, 0.75; 95% confidence interval [CI], 0.61-0.85). For oncology medications, the VAF had moderate inter-rater reliability (ICC, 0.63; 95% CI, 0.29-0.82). The UTSW VAF showed excellent overall inter-rater reliability for nononcology medications (ICC, 0.80; 95% CI, 0.62-0.90), with each individual criterion also showing moderate to excellent reliability, among 3 reviewers. CONCLUSION: This study showcases the development and retrospective evaluation of the inter-rater reliability of a novel institution-specific VAF for medication formulary review at UTSW. The VAF was determined to have good inter-rater reliability overall, with moderate, good, or excellent reliability across all categories. Most monographs scored in the low-intermediate to high-intermediate scoring range, with 3 monographs scoring in the high category.
Am J Health Syst Pharm
· 2026 May · PMID 41616080
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PURPOSE: Since the initial approval of direct oral anticoagulants (DOACs), multiple studies have concluded that DOACs were either noninferior or superior to vitamin K antagonist (VKA) for treatment of venous thromboembol...PURPOSE: Since the initial approval of direct oral anticoagulants (DOACs), multiple studies have concluded that DOACs were either noninferior or superior to vitamin K antagonist (VKA) for treatment of venous thromboembolism and prevention of cardioembolic stroke with less incidence of bleeding. Therefore, the objectives of this study were to identify eligible patients on VKA, conduct pharmacist-led therapeutic interchange from VKA to DOACs, and identify reasons for declining conversion. METHODS: This multicenter, prospective study was conducted at anticoagulation clinics at the Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center between July 2024 and July 2025. The first phase focused on screening for DOAC candidacy using a peer-reviewed DOAC conversion algorithm. The second phase consisted of prospective conversion of eligible patients from VKA to a DOAC. If patients declined conversion, the reason they declined was documented. RESULTS: A total of 496 patients were seen in the anticoagulation clinics of the Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center at the time of enrollment. Of the 193 eligible patients who were included in the study, 69 (35.8%) patients agreed to conversion, 104 (53.9%) declined conversion, 10 (5.2%) were lost to follow-up, and 10 (5.2%) were waiting to discuss conversion with their anticoagulation clinic provider. A total of 44 (22.8%) patients were successfully converted from VKA to a DOAC. Of the patients who declined conversion, 55 reported a preference for VKA therapy and 49 identified cost as a reason for declining conversion. CONCLUSION: Although most patients in both anticoagulation clinics remained on VKA therapy, a large proportion of patients were eligible to convert to DOACs. This study provides a framework for pharmacist-led VKA to DOAC conversions, which can be conducted on an annual basis.
Eichelberger AC, David CM, Johnson JL
… +1 more, Appeddu LA
Am J Health Syst Pharm
· 2026 Jan · PMID 41589061
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PURPOSE: This study aimed to determine whether the LACE index (length of stay, acuity of the hospital admission, comorbidities, emergency department visits in the previous 6 months) effectively identified patients at hig...PURPOSE: This study aimed to determine whether the LACE index (length of stay, acuity of the hospital admission, comorbidities, emergency department visits in the previous 6 months) effectively identified patients at high risk for readmission compared to identification solely by use of discharge diagnoses associated with high readmission rates. METHODS: The investigators retrospectively reviewed patient records based on predefined inclusion and exclusion criteria. The primary endpoint was the percentage of discharged patients with a LACE index score of at least 10 who received a transitions-of-care (TOC) visit compared to the percentage of discharged patients who were identified for these visits through existing methods. Secondary endpoints included the proportion of patients receiving a TOC visit by payor and the 30-day readmission rate of patients identified by LACE index vs traditional methods. RESULTS: Of the 161 patients included, 124 had a LACE index score of at least 10. While 49 of 161 patients (30.4%) received a TOC visit through existing methods, 43 of the 124 patients with a LACE index score of at least 10 (34.7%) received a TOC visit (P = 0.032). Furthermore, a higher proportion of patients with insurance other than Medicaid received TOC visits than those on Medicaid, representing a gap in patients who would benefit (P < 0.001). Overall, 36 patients were readmitted within 30 days, 33 (92%) of whom were at high risk for readmission based on LACE index score. In further evaluation, only 14 of the 36 patients who were readmitted (39%) had received a TOC visit. CONCLUSION: The LACE index potentially identified patients who could benefit from a TOC visit better than current methods. No difference was found between the methods for readmission rate, although significant limitations in study design could have affected the results. A method targeting patients for TOC visits could be explored by payors, as their patients could benefit from this service.
Braham MJ, Carter J, O'Neil DP
… +3 more, Phillips M, Miller K, Chaffee K
Am J Health Syst Pharm
· 2026 Jan · PMID 41578862
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PURPOSE: Medication costs have continued to rise over the past 2 decades, which causes a strain on health systems and patients. The purpose of this quality improvement project was to evaluate the implementation of a phar...PURPOSE: Medication costs have continued to rise over the past 2 decades, which causes a strain on health systems and patients. The purpose of this quality improvement project was to evaluate the implementation of a pharmacy analytics software program on medication expense and pharmacy operational efficiency at an academic medical center. METHODS: Twenty-five automated dispensing cabinets (ADCs) at an academic medical center located in emergency departments (n = 3), adult inpatient care areas (n = 16), and the adult intensive care units (n = 6) were optimized over a 3-month period. Omnicell Inventory Optimization Service, a data analytics program associated with the Omnicell OmniCenter technology platform, was utilized for optimization of identified ADCs. The endpoints of this quality improvement project were: (1) cost of expired medications from ADCs, (2) total inventory cost per ADC, (3) vend-to-fill ratio per ADC, (4) medication stock-outs per ADC, and (5) pharmacy technician time logged into ADCs. RESULTS: Twenty-five ADCs at an academic medical center were optimized over a 3-month period. During the optimization process, 7,206 stocked medications were analyzed and a total of 5,552 opportunities suggested were acted upon and implemented. The ADC optimizations yielded an overall decrease in the cost of expired medications, decrease in overall inventory cost, increase in vend-to-fill ratios, and optimization of overall technician efficiency, including reduced time required to restock ADCs and an increase in total items restocked per minute. CONCLUSION: The implementation of analytics software to assist with automated dispensing machine operational efficiency and quality can lead to a variety of improvements in pharmacy operational metrics.