HOSPITAL PHARMACY MEDICATION DELIVERY DURING COVID-19 PANDEMIC
European Statement
Selection, Procurement and Distribution
Author(s)
Andreia Fernandes, Mafalda Brito, Tatiana Mendes, Armando Alcobia
Why was it done?
Many patients had their health care needs compromised due to accessibility issues. They could not come to the PS because of the mandatory confinement, prophylactic isolation and medical indication.
What was done?
In the context of the Covid 19 pandemic, between April and June 2020, pharmaceutical Services (PS) instituted several alternatives delivery processes that guaranteed patients’ access to the medication, usually provided on the PS.
How was it done?
Pre-existing accessibility projects to deliver medication in community and hospital pharmacies have been adopted. In order to respond to all requests, new ways and protocols of medication distribution/delivery, like city hall transport, courier services and humanitarian aid (for example, motards), were created. For all deliveries outside PS, pharmaceutical telephone follow-up (teleconsultation) was realized.
What has been achieved?
7448 medication dispensations were registered, of which 80.7% were realized in person in the hospital PS (n = 6679). In the homolog period, 10621 dispensations were registered, of which 95.9% were in person (n = 10183).
438 deliveries were sent to community pharmacies, a total of 219 patients (54.3% female, maximum age 100, minimum 9 years). 41% increase compared to 2019. 198 shipments were realized to different hospitals and others healthcare units, corresponding to 120 patients (56 female, maximum age 85, minimum 8 years). 25% increase over the previous year.
New alternatives: City Hall 66 deliveries for 62 patients (58.0% female, minimum age 18, maximum 97 years), other deliveries 35 users (50.7% male, maximum age 94 and minimum age 10 years).
What next?
The Covid-19 pandemic triggered a need for adaptive evolution of pre-existing accessibility projects, but also the creation of new protocols and alternative means to respond to all patients who may have their healthcare compromised due to accessibility issues. The positive points were the implementation speed, maintenance of adherence to therapy (teleconsultation), traceability, reduced costs, synergy between patients/associations/pharmacists/healthcare professionals and a high degree of satisfaction. In spite of some limitations (dependent on volunteering; need for human resources; structured communication) we aspire to improve the new approaches of medication delivery on a nation level.
IMPLEMENTATION OF A SAFE EXTERNAL DISPENSING SYSTEM DURING THE COVID-19 PANDEMIC IN A REFERRAL HOSPITAL
Pdf
European Statement
Clinical Pharmacy Services
Author(s)
MARINA CORRALES PAZ, CLAUDIA RODRIGUEZ MORETA, INMACULADA LOMARES MANZANO, ANA GANFORNINA ANDRADES
Why was it done?
Due to the health crisis caused by the SARS-COV-2 virus, many hospitals have seen
the necessity to implement a safe dispensing system (telepharmacy) to provide medication to
high risk patients and those infected with Covid-19 in order to prevent interrupting their
treatments.
What was done?
To implement a system that guarantees a sure and effective supply of medical treatments to those vulnerable patients, those at increased risk or with difficult access to the hospital during the coronavirus pandemic.
How was it done?
A database was created with those patients attending our hospital’s outpatient service(OS)to pick up their medication within the next 7 days, verifying through pharmaceutical software and the patient’s medical history records (MHR)their next dispensing date. After checking if the patient had a medical appointmentthat could coincide with the dispensing date, a phone interview was conducted with the patient to schedule the pick-up of the medication through theOS or by telepharmacy(patients’ consent was requiredto use their personal information and we asked how the treatment was going). In our case the patients could pick-up their medication in the referral hospital (RH), a newly created OS in an affiliate hospital or by telepharmacy toprevent the collapse of the hospitals. We registered: number of patients attended in RH, new OS or by telepharmacy and number of dispensations. Patients were grouped in areas based on their city and delivery date for telepharmacy and in the case of patients picking up their own medication they were made an appointment.
What has been achieved?
During the months the state of emergency was in place in Spain (March 14th– June 21st)3385 patients were attended in total and 9316 medicationswere dispensed. 2245(66.3%) patients were attended in the RH (5794 dispensations), 583(17.2%) patients were attended through the new OS (1436 dispensations) and the rest 557(16.5%) had their medication sent to their address (2086 dispensations).
What next?
A safe and effective dispensing system was achieved to outpatients during the Covid-19 pandemic through the implementation of a new telepharmacymethod and the establishment of a new OSthat allows convenient dispensation of medication while minimising the risk of virus spread.
IMPLEMENTATION OF A TELEPHARMACY PROGRAMME TO HOSPITAL OUTPATIENTS DURING THE COVID-19 PANDEMIC
Pdf
European Statement
Selection, Procurement and Distribution
Author(s)
Rosalia Fernández-Caballero, Virginia Collados Arroyo, Clara Herranz Muñoz, Araceli Henares López
Why was it done?
Every month, an average of 700 patients receive pharmaceutical care in the outpatient consultation (OC) of our first-level hospital. Given the mobility restriction measures applied by the spanish government during the pandemic, access to this consultation was difficult for some patients. The aim of this program is to ensure the access to medication for all patients and prevent them and professionals to virus exposure. Telepharmacy program consists of providing pharmaceutical care based on available means of communication and access to medication through home drug delivery.
What was done?
During the COVID-19 pandemic, we designed and implemented a telepharmacy programm to ensure access to medication for all patients.
How was it done?
Once weekly, the pharmacist contacted the listed patients during the following week in OC by telephone or via the hospital’s electronic platform, to offer the possibility of participating in the program. During teleconsultation, pharmacist provided the same attention as in face-to face consultation: administrative situation of the patient, adequate medical follow-up, assessment of adherence, review of interactions and adverse events and treatment changes. Moreover, we e-mailed the patient’s consent for home drug delivery by and external company. In case the patient didn’t have a web mail, we requested verbal consent. Once a week, one pharmacy technician prepared the medication and the selected company performed the home delivery in guaranteed storage conditions. To minimize the burden of work, the medication was sent for two months per patient. Oncohematological patients, who came to their doctor’s appointment every month, were excluded from this program.
What has been achieved?
Between March 20 and October 9, we have included 595 patients in this program and conducted 1190 teleconsultations and 872 home drug deliveries with a great satisfaction of outpatients.
What next?
Our next step is to improve the web system for sending alerts through our electronic platform to automate the home delivery process and thereby to reduce the logistic burden of the pharmacist and to increase the pharmaceutical care given to patients.
ASSORTMENT COUNCIL SECURES THAT MEDICAL PRODUCT AND INFORMATION IS AVAILABLE TO NURSES, PHYSICIANS AND PHARMACISTS (submitted in 2019)
Pdf
European Statement
Selection, Procurement and Distribution
Author(s)
Katja Heikkinen, Charlotta Vinterflod
Why was it done?
AC’s mission is to secure that the right product and product information is available as well as in case of shortages assist with alternative products and information. Correct information is fundamental to achieve an effective and secure supply chain of medical products. This reduces time spent on ordering, delivery time is shortened and finding information is more efficient.
What was done?
The hospital pharmacy in Region Västra Götaland, Sweden (VGR) established an assortment council (AC) that assists buyers of medical products within the region. By creating a defined assortment the goal was to direct healthcare professionals to order procured, recommended and cost-efficient medicines and enable structured availability monitoring.
How was it done?
A counsel of pharmacists was formed to administer a defined assortment consisting of 95% of the most commonly used medical products. The availability is monitored daily and every disruption of supply is handled in a structured way. Alternative marketed or unlicensed medical products are identified and information about these are communicated through VGR’s ordering system or by newsletters. If an equivalent product is available, it will be delivered automatically without the need for placing a new order. The AC also collaborates with the region’s medical specialists and drug and therapeutics committee (DTC) when searching for alternatives.
What has been achieved?
Defined assortment has been reduced from 6000 products to approximately 3000. In 2018 in addition to the daily updated availability information, 14,300 orders out of 410,000 were automatically replaced with an equivalent product and 41 newsletters about shortages were published. Nurses get more time for patient care when shortages information is readily available, and replacement of equivalent products can be delivered automatically
What next?
By implementing this way of working in other hospital regions or on a national level, caregivers would be able to free up resources and focus on patient care and at the same time be able to find quality assured information about shortages and alternatives in an efficient manner.