Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2011

Open Access 01-12-2011 | Study protocol

Cost-effectiveness of ward-based pharmacy care in surgical patients: protocol of the SUREPILL (Surgery & Pharmacy In Liaison) study

Authors: Monica de Boer, Maya A Ramrattan, Jordy JS Kiewiet, Eveline B Boeker, Kim B Gombert-Handoko, Nicolette AEM van Lent-Evers, Paul F Kuks, Marcel GW Dijkgraaf, Marja A Boermeester, Loraine Lie-A-Huen, the SUREPILL study group

Published in: BMC Health Services Research | Issue 1/2011

Login to get access

Abstract

Background

Preventable adverse drug events (pADEs) are widely known to be a health care issue for hospitalized patients. Surgical patients are especially at risk, but prevention of pADEs in this population is not demonstrated before. Ward-based pharmacy interventions seem effective in reducing pADEs in medical patients. The cost-effectiveness of these preventive efforts still needs to be assessed in a comparative study of high methodological standard and also in the surgical population. For these aims the SUREPILL (Surgery & Pharmacy in Liaison) study is initiated.

Methods/Design

A multi-centre controlled trial, with randomisation at ward-level and preceding baseline assessments is designed. Patients admitted to the surgical study wards for elective surgery with an expected length of stay of more than 48 hours will be included. Patients admitted to the intervention ward, will receive ward-based pharmacy care from the clinical pharmacy team, i.e. pharmacy practitioners and hospital pharmacists. This ward-based pharmacy intervention includes medication reconciliation in consultation with the patient at admission, daily medication review with face-to-face contact with the ward doctor, and patient counselling at discharge. Patients admitted in the control ward, will receive standard pharmaceutical care.
The primary clinical outcome measure is the number of pADEs per 100 elective admissions. These pADEs will be measured by systematic patient record evaluation using a trigger tool. Patient records positive for a trigger will be evaluated on causality, severity and preventability by an independent expert panel. In addition, an economic evaluation will be performed from a societal perspective with the costs per preventable ADE as the primary economic outcome. Other outcomes of this study are: severity of pADEs, number of patients with pADEs per total number of admissions, direct (non-)medical costs and indirect non-medical costs, extra costs per prevented ADE, number and type of pharmacy interventions, length of hospital stay, complications registered in a national complication registration system for surgery, number of readmissions within three months after initial admission (follow-up), quality of life and number of non-institutionalized days during follow-up.

Discussion

This study will assess the cost-effectiveness of ward-based pharmacy care on preventable adverse drug events in surgical patients from a societal perspective, using a comparative study design.

Trial registration

Netherlands Trial Register (NTR): NTR2258
Appendix
Available only for authorised users
Literature
1.
Morimoto T, Gandhi TK, Seger AC, Hsieh TC, Bates DW: Adverse drug events and medication errors: detection and classification methods. Qual Saf Health Care. 2004, 13: 306-314. 10.1136/qshc.2004.010611.CrossRefPubMedPubMedCentral
2.
Page RL, Ruscin JM: The risk of adverse drug events and hospital-related morbidity and mortality among older adults with potentially inappropriate medication use. Am J Geriatr Pharmacother. 2006, 4: 297-305. 10.1016/j.amjopharm.2006.12.008.CrossRefPubMed
3.
Rodriguez-Monguio R, Otero MJ, Rovira J: Assessing the economic impact of adverse drug effects. Pharmacoeconomics. 2003, 21: 623-650. 10.2165/00019053-200321090-00002.CrossRefPubMed
4.
Bates DW, Spell N, Cullen DJ, Burdick E, Laird N, Petersen LA, et al: The costs of adverse drug events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA. 1997, 277: 307-311. 10.1001/jama.277.4.307.CrossRefPubMed
5.
de Vries EN, Ramrattan MA, Smorenburg SM, Gouma DJ, Boermeester MA: The incidence and nature of in-hospital adverse events: a systematic review. Qual Saf Health Care. 2008, 17: 216-223. 10.1136/qshc.2007.023622.CrossRefPubMedPubMedCentral
6.
Bates DW, Leape LL, Petrycki S: Incidence and preventability of adverse drug events in hospitalized adults. J Gen Intern Med. 1993, 8: 289-294. 10.1007/BF02600138.CrossRefPubMed
7.
Bates DW, Cullen DJ, Laird N, Petersen LA, Small SD, Servi D, et al: Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. JAMA. 1995, 274: 29-34. 10.1001/jama.274.1.29.CrossRefPubMed
8.
Bates DW, Boyle DL, Vander Vliet MB, Schneider J, Leape L: Relationship between medication errors and adverse drug events. J Gen Intern Med. 1995, 10: 199-205. 10.1007/BF02600255.CrossRefPubMed
9.
Bates DW, Miller EB, Cullen DJ, Burdick L, Williams L, Laird N, et al: Patient risk factors for adverse drug events in hospitalized patients. ADE Prevention Study Group. Arch Intern Med. 1999, 159: 2553-2560. 10.1001/archinte.159.21.2553.CrossRefPubMed
10.
Classen DC, Pestotnik SL, Evans RS, Burke JP: Computerized surveillance of adverse drug events in hospital patients. JAMA. 1991, 266: 2847-2851. 10.1001/jama.266.20.2847.CrossRefPubMed
11.
Gholami K, Shalviri G: Factors associated with preventability, predictability, and severity of adverse drug reactions. Ann Pharmacother. 1999, 33: 236-240. 10.1345/aph.17440.CrossRefPubMed
12.
Nebeker JR, Hoffman JM, Weir CR, Bennett CL, Hurdle JF: High rates of adverse drug events in a highly computerized hospital. Arch Intern Med. 2005, 165: 1111-1116. 10.1001/archinte.165.10.1111.CrossRefPubMed
13.
Rothschild JM, Landrigan CP, Cronin JW, Kaushal R, Lockley SW, Burdick E, et al: The Critical Care Safety Study: The incidence and nature of adverse events and serious medical errors in intensive care. Crit Care Med. 2005, 33: 1694-1700. 10.1097/01.CCM.0000171609.91035.BD.CrossRefPubMed
14.
Senst BL, Achusim LE, Genest RP, Cosentino LA, Ford CC, Little JA, et al: Practical approach to determining costs and frequency of adverse drug events in a health care network. Am J Health Syst Pharm. 2001, 58: 1126-1132.PubMed
15.
Kaboli PJ, Hoth AB, McClimon BJ, Schnipper JL: Clinical pharmacists and inpatient medical care: a systematic review. Arch Intern Med. 2006, 166: 955-964. 10.1001/archinte.166.9.955.CrossRefPubMed
16.
Kucukarslan SN, Peters M, Mlynarek M, Nafziger DA: Pharmacists on rounding teams reduce preventable adverse drug events in hospital general medicine units. Arch Intern Med. 2003, 163: 2014-2018. 10.1001/archinte.163.17.2014.CrossRefPubMed
17.
Leape LL, Cullen DJ, Clapp MD, Burdick E, Demonaco HJ, Erickson JI, et al: Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA. 1999, 282: 267-270. 10.1001/jama.282.3.267.CrossRefPubMed
18.
Bond CA, Raehl CL, Franke T: Clinical pharmacy services, pharmacy staffing, and the total cost of care in United States hospitals. Pharmacotherapy. 2000, 20: 609-621. 10.1592/phco.20.7.609.35169.CrossRefPubMed
19.
Dooley MJ, Allen KM, Doecke CJ, Galbraith KJ, Taylor GR, Bright J, et al: A prospective multicentre study of pharmacist initiated changes to drug therapy and patient management in acute care government funded hospitals. Br J Clin Pharmacol. 2004, 57: 513-521. 10.1046/j.1365-2125.2003.02029.x.CrossRefPubMedPubMedCentral
20.
Nesbit TW, Shermock KM, Bobek MB, Capozzi DL, Flores PA, Leonard MC, et al: Implementation and pharmacoeconomic analysis of a clinical staff pharmacist practice model. Am J Health Syst Pharm. 2001, 58: 784-790.PubMed
21.
Rijdt De, Willems L, Simoens S: Economic effects of clinical pharmacy interventions: a literature review. Am J Health Syst Pharm. 2008, 65: 1161-1172. 10.2146/ajhp070506.CrossRefPubMed
22.
Resar RK, Rozich JD, Classen D: Methodology and rationale for the measurement of harm with trigger tools. Qual Saf Health Care. 2003, 12 (Suppl 2): ii39-ii45.PubMedPubMedCentral
23.
Griffin FA, Classen DC: Detection of adverse events in surgical patients using the Trigger Tool approach. Qual Saf Health Care. 2008, 17: 253-258. 10.1136/qshc.2007.025080.CrossRefPubMed
24.
25.
Classen DCM, Lloyd RCP, Provost LP, Griffin FAR, Resar RM: Development and Evaluation of the Institute for Healthcare Improvement Global Trigger Tool. Journal of Patient Safety. 2008, 4: 169-177. 10.1097/PTS.0b013e318183a475. ArticleCrossRef
26.
Cohen MM, Kimmel NL, Benage MK, Cox MJ, Sanders N, Spence D, et al: Medication safety program reduces adverse drug events in a community hospital. Qual Saf Health Care. 2005, 14: 169-174. 10.1136/qshc.2004.010942.CrossRefPubMedPubMedCentral
27.
Rozich JD, Haraden CR, Resar RK: Adverse drug event trigger tool: a practical methodology for measuring medication related harm. Qual Saf Health Care. 2003, 12: 194-200. 10.1136/qhc.12.3.194.CrossRefPubMedPubMedCentral
28.
29.
Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al: A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981, 30: 239-245. 10.1038/clpt.1981.154.CrossRefPubMed
30.
31.
32.
van Roijen L, Essink-Bot ML, Koopmanschap MA, Bonsel G, Rutten FF: Labor and health status in economic evaluation of health care. The Health and Labor Questionnaire. Int J Technol Assess Health Care. 1996, 12: 405-415. 10.1017/S0266462300009764.CrossRefPubMed
33.
34.
Lada P, Delgado G: Documentation of pharmacists' interventions in an emergency department and associated cost avoidance. Am J Health Syst Pharm. 2007, 64: 63-68. 10.2146/ajhp050213.CrossRefPubMed
35.
Smythe MA, Shah PP, Spiteri TL, Lucarotti RL, Begle RL: Pharmaceutical care in medical progressive care patients. Ann Pharmacother. 1998, 32 (3): 294-299. 10.1345/aph.17068.CrossRefPubMed
36.
Oostenbrink JB, Bouwmans CAM, Koopmanschap MA, Rutten FFH: Manual for cost-studies: methods and unit prices for economic evaluations in health care (in Dutch). Dutch Health Care insurance board. 2004
37.
Koopmanschap MA, Rutten FFH, van Ineveld BM, van Roijen L: The friction cost method for measuring indirect costs of disease. J Health Econ. 1995, 14: 171-189. 10.1016/0167-6296(94)00044-5.CrossRefPubMed
38.
Dean B, Schachter M, Vincent C, Barber N: Causes of prescribing errors in hospital inpatients: a prospective study. Lancet. 2002, 359: 1373-1378. 10.1016/S0140-6736(02)08350-2.CrossRefPubMed
39.
Metadata
Title
Cost-effectiveness of ward-based pharmacy care in surgical patients: protocol of the SUREPILL (Surgery & Pharmacy In Liaison) study
Authors
Monica de Boer
Maya A Ramrattan
Jordy JS Kiewiet
Eveline B Boeker
Kim B Gombert-Handoko
Nicolette AEM van Lent-Evers
Paul F Kuks
Marcel GW Dijkgraaf
Marja A Boermeester
Loraine Lie-A-Huen
the SUREPILL study group
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2011
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-11-55

Other articles of this Issue 1/2011

BMC Health Services Research 1/2011 Go to the issue

Research article

Urbanization and physician maldistribution: a longitudinal study in Japan

Research article

Health care use and costs of adverse drug events emerging from outpatient treatment in Germany: A modelling approach

Research article

Reliability of INTERMED Spanish version and applicability in liver transplant patients: a cross-sectional study

Research article

Expert Delphi survey on research and development into drugs for neglected diseases

Research article

Facility and home based HIV Counseling and Testing: a comparative analysis of uptake of services by rural communities in southwestern Uganda

Study protocol

Effectiveness of classroom based crew resource management training in the intensive care unit: study design of a controlled trial