Related Experiment Video
Updated: Jun 28, 2025
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Medication Management Through Collaborative Practice for Children With Medical Complexity: A Prospective Case Series
Jena Quinn1, Heather Monk Bodenstab1,2, Emily Wo1
1Perfecting Peds (JQ, HMB, EW), Haddon Heights, NJ.
Insights
Pharmacists improved medication management for children with special health care needs, reducing drug problems and costs. This collaborative approach decreased hospital readmissions and medication burden for these complex patients.
Area of Science:
- Pharmacotherapy
- Pediatric Long-Term Care
- Health Services Research
Background:
- Medication management for children and youth with special health care needs and medical complexity (CYSHCN-CMC) presents significant challenges for providers, families, and patients.
- Effective care coordination, particularly for pharmacotherapy, is crucial for improving health outcomes and reducing healthcare utilization in this population.
Purpose of the Study:
- To describe the implementation of a clinical pharmacotherapy practice within a pediatric long-term care facility (pLTCF).
- To detail the application of standard operating procedures for comprehensive medication management (CMM) guided by a collaborative practice agreement (CPA).
- To evaluate the impact of pharmacist-led CMM on drug therapy problems (DTPs), medication burden, healthcare costs, and hospital readmissions in CYSHCN-CMC.
Main Methods:
- A prospective case series design was employed over a 9-month period.
- 102 patients identified as CYSHCN-CMC were enrolled in this quality improvement project at a pLTCF.
- Pharmacists utilized a CPA to conduct CMM, identifying and resolving DTPs, and assessing medication regimens.
Main Results:
- Pharmacists identified, prevented, or resolved 1355 DTPs (average 13 per patient), reducing the average number of medications per patient from 23 to 20.
- Significant cost savings and avoidance were observed, totaling $44,304 monthly in direct cost savings and $48,835 monthly in cost avoidance.
- The intervention led to a 44% reduction in hospital readmissions, avoidance of 28 ED visits/admissions, and 61 clinic/urgent care visits. Pharmacist recommendations were accepted at a 98% rate.
Conclusions:
- Implementing a CPA for CMM in CYSHCN-CMC effectively decreased medication burden and resolved/prevented adverse drug events.
- The collaborative pharmacotherapy practice resulted in substantial reductions in healthcare-related costs and hospital readmissions.
- The model was well-accepted and collaboratively implemented by pLTCF providers, demonstrating its feasibility and value.
Objective:
Care coordination for children and youth with special health care needs and medical complexity (CYSHCN-CMC), especially medication management, is difficult for providers, parents/caregivers, and -patients. This report describes the creation of a clinical pharmacotherapy practice in a pediatric long-term care facility (pLTCF), application of standard operating procedures to guide comprehensive medication management (CMM), and establishment of a collaborative practice agreement (CPA) to guide drug therapy.
Methods:
In a prospective case series, 102 patients characterized as CYSHCN-CMC were included in this pLTCF quality improvement project during a 9-month period.
Results:
Pharmacists identified, prevented, or resolved 1355 drug therapy problems (DTP) with an average of 13 interventions per patient. The patients averaged 9.5 complex chronic medical conditions with a -median length of stay of 2815 days (7.7 years). The most common medications discontinued due to pharmacist assessment and recommendation included diphenhydramine, albuterol, sodium phosphate enema, ipratropium, and metoclopramide. The average number of medications per patient was reduced from 23 to 20. A pharmacoeconomic analysis of 244 of the interventions revealed a monthly direct cost savings of $44,304 ($434 per patient per month) and monthly cost avoidance of $48,835 ($479 per patient per month). Twenty-eight ED visits/admissions and 61 clinic and urgent care visits were avoided. Hospital -readmissions were reduced by 44%. Pharmacist recommendations had a 98% acceptance rate.
Conclusions:
Use of a CPA to conduct CMM in CYSHCN-CMC decreased medication burden, resolved, and prevented adverse events, reduced health care-related costs, reduced hospital readmissions and was well-accepted and implemented collaboratively with pLTCF providers.
More Related Videos
08:13Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Published on: January 20, 2019
11:17Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Related Concept Videos
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:28Drug Therapy
Antianxiety Medications
01:26Methods of Documentation II: POMR
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
Assessment
01:21Factors Affecting Drug Response: Overview
01:27Nursing Clinical Information System
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include: