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Record W2170317542 · doi:10.4212/cjhp.v63i6.959

Pharmacists Making House Calls:Innovative Role or Overkill?

2010· article· en· W2170317542 on OpenAlexaffvenueabout
Priti S. Flanagan, Adil Virani, Warren J. Baker, Hendrik Roelants

Bibliographic record

VenueThe Canadian Journal of Hospital Pharmacy · 2010
Typearticle
Languageen
FieldMedicine
TopicPharmaceutical Practices and Patient Outcomes
Canadian institutionsFraser Health
Fundersnot available
KeywordsPharmacistMedicineIntervention (counseling)Family medicineMedication therapy managementHealth careHealth servicesHome healthClinical pharmacyDrug Utilization ReviewEmergency medicineMedical emergencyNursingPharmacyEnvironmental healthMedical prescriptionPopulation

Abstract

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Background: The Medication Management Program was established at the Fraser Health Authority in 2005, in response to evidence suggesting that having pharmacists provide care to patients in their homes after discharge from hospital could reduce subsequent utilization of health service resources. Objective: To determine the effectiveness of the Medication Management Program in its first 2 years of operation. Methods: For patients who had received a home visit by a pharmacist, the utilization of health services (admissions to hospital, physician office visits, and dispensed medications) in the year before the home visit was compared with utilization during the year after the intervention. The net cost of the program was also determined. Results: In the first 2 years of the Medication Management Program (2005/2006 and 2006/2007), a total of 1171 patients received a home visit from a pharmacist. Of these, 836 (71%) were included in the before and-after analysis. The median per-patient cost for utilization of health services was $11 014 lower in the year after the intervention than in the year preceding the intervention. After the costs of the program were taken into account, this resulted in a net median cost reduction of $3047.43 per patient. Conclusion: The Medication Management Program was effective as a clinical program in its first 2 years. RÉSUMÉ Contexte : Le Programme de gestion des médicaments a été mis en oeuvre en 2005 à la Fraser Health Authority en Colombie-Britannique, à la lumière de données suggérant que des soins à domicile prodigies par des pharmaciens à des patients après leur congé de l'hôpital pourraient réduire l'utilisation subséquente des ressources en soins de santé. Objectif : Déterminer l'efficacité du Programme de gestion des médicaments dans les deux premières années de son existence. Méthodes :On a comparé l'utilisation de services de santé (hospitalisations, consultations médicales et médicaments délivrés) de patients ayant reçu des soins à domicile par un pharmacien dans l'année précédant la visite du pharmacien à domicile à l'utilisation de ces ressources dans l'année suivant l'intervention. On a également calculé le coût net du programme. Résultats : Dans les deux premières années du Programme de gestion des médicaments (2005-2006 et 2006-2007), un total de 1171 patients ont reçu une visite à domicile d'un pharmacien. De ces patients, 836 (71 %) ont été inclus dans l'analyse pré- et post-intervention. Le coût médian par patient de l'utilisation des services de santé était inférieur de 11 014 $ dans l'année suivant l'intervention, comparativement à l'année précédant l'intervention. Après avoir tenu compte du coût du programme, la réduction du coût net median était de 3047,43 $ par patient. Conclusion : Le Programme de gestion des médicaments s'est avéré efficace comme intervention clinique dans ses deux premières années.

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How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.007
metaresearch head score (Gemma)0.030
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.017
Threshold uncertainty score0.058

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0070.030
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0010.001
Science and technology studies0.0020.002
Scholarly communication0.0040.003
Open science0.0020.003
Research integrity0.0030.003
Insufficient payload (model declined to judge)0.0170.002

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.094
GPT teacher head0.408
Teacher spread0.313 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreCommentary

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations13
Published2010
Admission routes3
Has abstractyes

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Same venueThe Canadian Journal of Hospital PharmacySame topicPharmaceutical Practices and Patient OutcomesFrench-language works237,207