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An Educational Intervention to Decrease Drug Costs Related to Terminal Secretions in a Hospice Organization.

Cara Brock, Sarah Cooper, Christopher M Herndon

    Journal of Pain & Palliative Care Pharmacotherapy
    |March 14, 2017
    PubMed
    Summary
    This summary is machine-generated.

    An educational intervention significantly reduced hospice drug costs for terminal secretions by educating staff on medication efficacy, safety, and cost. This approach saved hospice organizations money while maintaining patient symptom management.

    Keywords:
    Web-basedanticholinergicscostseducationglycopyrrolatehyoscyaminepalliative caresecretionsterminal

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    Area of Science:

    • Palliative Care
    • Pharmacoeconomics
    • Hospice Medicine

    Background:

    • Terminal secretions are a common symptom in hospice patients.
    • Antimuscarinic drugs are frequently used for treatment, but evidence is limited and costs vary.
    • High medication costs impact hospice organizations.

    Purpose of the Study:

    • To assess the impact of an educational intervention on the utilization and cost of medications for terminal secretions.
    • To evaluate the cost-effectiveness of treating terminal secretions in hospice care.

    Main Methods:

    • Hospice program data were analyzed to identify high-cost medications for terminal secretions.
    • An educational intervention (EI) focused on transdermal scopolamine's efficacy, safety, and cost.
    • Drug utilization and costs were re-evaluated post-intervention.

    Main Results:

    • Following the EI, total monthly drug costs decreased by 22.5%.
    • Average drug cost per patient per day decreased by 11.1%.
    • Total anti-secretion medication costs decreased by 28.5% after adjusting for patient census.

    Conclusions:

    • Education on medication use and cost for end-of-life symptoms can lead to significant cost savings in hospice.
    • This intervention maintained appropriate symptom management for patients.
    • Further interventions targeting other high-cost medications are recommended.