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The Pharmacist’s News Source
pharmacypracticenews.com
Volume 39 • Number 5 • May 2012
Printer-friendly versions available online
Changes Are Coming For Stress Ulcer Prevention Therapy
in this issue Up Front
In Brief Another reason for your patients to quit smoking.
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Experts preview pending guidelines Houston—Health care professionals anxiously awaiting the updated stress ulcer prophylaxis guidelines will have to wait until the end of 2012, but they should be aware that a wealth of new data has turned the previous guideline document on its head. During a session at the recent annual meeting of the Society of Critical Care Medicine, speakers involved in the development of the guidelines offered a quick preview. The new guidelines touch on areas including preferred therapy choice, patient selection factors and when to start and stop therapy. Clinicians in doubt as to whether to initiate therapy should go ahead and start, said presenter Douglas Naylor Jr., MD, staff intensivist
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see STRESS, page 7
Clinical
Critical Care Weight-based dosing in ER still taken too lightly. Medication errors and C. difficile infections pose big risks in ICUs.
Ipilimumab dose rounding and fixed dosing of rasburicase yield major cost savings.
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Ethics
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Operations & Mgmt
With CMS Pay Cuts Looming, Hospitals Eye Readmissions
see READMISSIONS, page 52
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Hem/Onc Pharmacy
Reimbursement
early 18% of all Medicare patients who are admitted to hospitals are readmitted within 30 days after discharge, at a cost of $15 billion annually—about $7,200 per case—according to the Medicare Payment Advisory Commission (MedPac). The commission also asserts that two-thirds of those readmissions are avoidable. Starting in 2013, the Center for Medicare & Medicaid Services (CMS) will reduce payments to hospitals that log excessive readmissions related to heart failure (HF), acute myocardial infarction (AMI) and pneumonia. Private insurers are likely to follow suit, and the prospect has hospitals scrambling to reduce readmission rates. Fortunately, there are several strategies that hospitals can follow to keep patients at home. One effective approach—leveraging multidisciplinary care and pharmacy services to help patients avoid drug-related adverse events— was the focus of a recent Web-based seminar
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A team approach to surviving RAC audits, maximizing reimbursement.
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Policy Yet another retraction of published studies shines spotlight on research ethics.
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FDA Watch New proposed rule on biosimilars inches the market closer to generic biologics.
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Educational Review
Catheterrelated Bloodstream Infections See page 11
Drug Shortages Continue To Chip Away at Patient Care At HOPA annual meeting, pharmacists, FDA share coping strategies Orlando, Fla.—If the start of this year is any indication, the drug shortage crisis is likely to escalate in 2012. “By about the second week of February, we already had exceeded 40 new drug shortages,” said Dan Sageser, PharmD, BCOP, clinical pharmacy supervisor at the Huntsman Cancer Institute, Salt Lake City. That placed the hospital on track to exceed the 267 drug shortages it dealt with in 2011, Dr. Sageser said during a session on drug shortages at the annual meeting of the Hematology/Oncology Pharmacy Association (HOPA). By early April, although the number of new shortages at the Institute has remained stable at 40, “we currently have 263 active shortages we are dealing with—most of which are holdovers from last year. So there’s not much relief in sight,” he noted via email after the HOPA meeting.
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see DRUG SHORTAGES, page 28
Rivaroxaban Edges Standard Therapy for Pulmonary Embolism Regimen allows substantial reductions in hospital LOS Chicago—The factor Xa inhibitor rivaroxaban was as effective as standard therapy in the treatment of pulmonary embolism (PE) but yielded a 50% reduction in the incidence of major bleeding and allowed for a simplified regimen that enabled patients to spend less time in the hospital, according to the results of a large, multinational study.
Featured Service
GlobalHealth Education offers graduate credential in management program. See page 24.
The fixed-dose oral regimen could offer a viable alternative to subcutaneous injections of enoxaparin and vitamin K antagonist, which is complex and requires very close monitoring, reported investigator Harry R. Buller, MD, PhD, at the annual meeting of the American College of Cardiology (ACC).
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see ADVANTAGES, page 32
New Product American Health Packaging introduces new unit-dose products. See page 25.
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