Drug Topics - October 22, 2007 - (Page H15)

HSE 15 Pharmacists playing more important role in dialysis treatment Michael Barbella N ot much has changed for Ronald J. Abrahams since he retired two years ago from Hartford Hospital. He still wakes up early—a habit his body is having trouble breaking—and commutes to the hospital every day to tend to patients. Abrahams’ professional routine is still the same, too, with one small exception: He tends to fewer patients. Since retiring, Abrahams has put his skills as a pharmacist to work in the hospital’s dialysis unit. He is a one-man band, responsible for reviewing lab reports and patients’ medical histories and coming up with drug therapies for the nearly 200 patients undergoing dialysis. “When I was working full time, I did the dialysis in addition to my regular duties,” Abrahams said. “The dialysis was a small part of my daily routine. Now I can concentrate all of my energies on dialysis.” Abrahams is among a small group of pharmacists who focus exclusively on dialysis patients. Practically unheard of 15 or 20 years ago, hospitals are now beginning to realize the benefits of dedicating a pharmacist to end-stage renal disease (ESRD) patients. More than 375,000 Americans suffer from ESRD, and more than 90,000 new cases are diagnosed annually, according to the National Kidney Foundation. Some states—such as New Jersey and Florida—require dialysis centers to have a pharmacist on staff. New Jersey requires pharmacists in these centers to review policies and procedures, offer educational programs, review medical records on a quarterly basis, and submit quarterly written reports. Two years ago, the Centers for Medicare & Medicaid Services mulled a proposal to require pharmacists to play a more active role in reviewing medication regimens for dialysis patients. The proposal, supported by ASHP, said pharmacists “have the education and experience to provide critical services that can promote safer and more effective medication use.” “These are high-risk patients,” said Teresa Rubio, Pharm.D., director, Section of Inpatient Care Practitioners for ASHP. “Pharmacist involvement with this population is really important. A pharmacist can detect and resolve medication issues as a member of the dialysis healthcare team.” Pharmacists also can counsel ESRD patients and act as a resource for nurses working in the unit. Per- haps more important, having a pharmacist involved in dialysis enables nurses to better care for ESRD patients. Before he retired, Abrahams spent two hours a day addressing questions from nurses assigned to the dialysis unit and initiating new drug therapies for patients. He was given two eight-hour days each month to evaluate lab reports, monitor the unit’s 190 patients, and write orders. Since retiring, he has turned that 16hour stint each month into 80—an At top, Hartford Hospital’s increase he claims allows him to better dialysis unit. Above are control patients’ anemia and nurses to Timothy Nguyen (l.), of Holy Name Hospital’s Regional better treat other medical conditions as- Dialysis Center, and sociated with ESRD. Holy Name’s pharmacy “Before, nurses had to draw up the director, Russ Lazzaro. drugs and that took a considerable amount of time,” he explained. “Now, the nurses can interact with doctors and care for some of the other conditions that patients have, such as diabetes.” Multiple benefits Adding a pharmacist to the dialysis unit benefits not only patients but healthcare practitioners and providers as well. Nurses, for example, can learn about medication management and dosing by simply observing dialysis unit pharmacists, said Timothy Nguyen, a hemodialysis pharmacist at Holy Name Hospital in Teaneck, N.J. “Closely watching the administration of medication is beneficial,” noted Nguyen, who oversees 210 dialysis patients every week. “Nurses cannot really do medication orders. They do not have a background in medication therapy management, and most of the time they are way too busy. Pharmacists can help the nursing staff with [patient] protocols and medication management. Nurses can learn from the pharmacist.” Abrahams agreed. In an article he wrote for ASHP,

Table of Contents Feed for the Digital Edition of Drug Topics - October 22, 2007

Drug Topics - October 22, 2007 Contents Latebreakers Legislative Victory Builds Momentum for Pharmacy Month Letters Health-System Edition R.Ph.s Brace for Payment Denial for Hospital-Acquired Conditions Topical Human Thrombin Helps Arrest Bleeding FDA Panels Fail to Set Target Levels for Renal Patients’ Hemoglobin Warning Letters Raise Patient Safety Concerns for Fentora Ending/Reversing Weight Gain Man Given Fatal Drug Overdose at Staten Island Hospital Pharmacists Playing More Important Role in Dialysis Treatment AHA President R.Ph.'s Here's How You Can Increase Your Value Premier Launches Comprehensive Quality Improvement Project FDA Approves Dexrazoxane for Treatment of Extravasation New Federal, State Reforms to Ease Disaster Relief Kinks 150 Years of American Pharmacy Ten Tips for MTM Success Independent Superstars: The Ones to Watch The New Dynamic Duo A Parkinson's Disease Primer Classified New Products Advertisers Index Viewpoint

Drug Topics - October 22, 2007

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