Pharmaceutical care to Pediatric Home Health Care

Why was it done?

Home Health Care is a new emerging model of health care, with a great impact on pediatrics.
Pharmaceutical care is relevant in these population because:

•The pediatric patient,for many reasons, involves difficulties in the use of medications (adaptation of pharmaceutical forms, preparation of magistral formula, off-label use, need for calculations, etc.).
•Health education is esencial to family/primary caregiver of patients admitted at home

What was done?

Reciently a pharmacist has joined to multidisciplinary Home Health Care team.

How was it done?

Pharmaceutical Care consists on:

• Clinical and pharmacotherapeutic daily follow up

• Medication reconciliation for polymedicated patients, with narrow therapeutic range drugs, or chronic diseases (oncological, neurological…)

• Pharmaceutical validation, verifying: the indication, dosage, route of administration, drug interactions, adequacy of the dosage form to the patient’s situation

• Compounding sterile preparations at Pharmacy Service. It allows a longer storage period of them, so it will reduce nursing/medical visits to home in patients with stable health condition, so the unit can admitted more patients

• Active participation in multidisciplinary sessions to advise on pharmacological issues and ensure the maximum efficiency and safety of the treatments

• Dispensing weekly of prescribed medication

• Registration of pharmaceutical interventions and cost saving by compounding sterile preparations

What has been achieved?

The average of pharmaceutical interventions during six months were 17,5 per month, 90.7% were accepted. It means that 57,4% of admited patients to Pediatric Home Health Care Unit were done a pharmaceutical intervention.

The types of pharmaceutical interventions were: 35,3% for dosing of drugs, 27% for pharmacokinetic monitoring, 18% for medication use, 4% by prescription error, 4% for preparation and administration of drugs at home. Others were about monitoring side effects and medication acquisition.

Finally, 657 sterile preparations were compounding at Pharmacy Service, it has involved a cost saving of 5143€.

What next?

It is neccesary an individualized pharmaceutical care to chronic, polymedicated and pluripathological pediatric patient in Home Health Care Unit. It will be performed:

• Clinical and pharmacotherapeutic telematic follow up
• Telephone/telematic assistance with the pharmacist for any doubts about the use of drugs
• A personalized report with individualized recomendations about preparation, administration, manipulation, elimination and acquisition of drugs.