@article {154, title = {The Economic Outcomes of Pharmacist Interventions in Total Parenteral Nutrition Services in Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {September 2019}, pages = {S40-S49}, type = {Research Article}, chapter = {S40}, abstract = {

Objectives: There are several problems and complications related to the Total Parenteral Nutrition (TPN) services. The pharmacist plays a crucial role in preventing these problems. Therefore, in this study, we aimed to assess the economic outcomes of pharmacist intervention in cost avoidance related to TPN services at a public hospital in Riyadh city, Saudi Arabia. Methods: Cohort prospective analysis of data collected regarding pharmacist intervention in TPN services provided to neonates, pediatrics and adult patients was performed. TPN services were provided 8 hr in a day and 7 days in a week. The study site was a 300-bed public hospital at the Ministry of Health (MOH) in Riyadh city, Saudi Arabia. The pharmacist reviews and prepares TPN and he pharmacist documents any or all TPN-related problems before the preparation of TPN or after dispensing it. The pharmacist uses an International Study Model to measure level of activity and provides rational of clinical intervention, recommendation, patient outcome, impact of pharmacoeconomics and related cost analysis. Results: The pharmacist identified a total of 402 TPN-related problems. The total number of TPN services provided was 394 prescribed to 82 patients. Of these, 209 (51.99\%) and 193 (48.01\%) interventions were provided to males and females, respectively. The total cost avoidance from pharmacist intervention in 1 year was 578,926.89 USD. The highest cost avoidance of TPN interventions was recorded for potentially significant (54.90\%; 100,040.91 USD) and potentially serious problems (33.33\%; 244,696.83 USD). The maximum cost avoidance in the case of rational clinical activities was recorded for TPN consultations (325,695.76 USD) followed by incompatibility (275,802.66) and inappropriate route (189,912.34 USD). The maximum cost avoidance related to patient outcome was recorded for patient condition improved (489,830.93 USD) and laboratory value improved (89,095.96). The maximum pharmacoeconomic cost avoidance impact was the patient duration of hospital stay decreased (226; 332,220.70 USD) and reduction in the drug therapy monitoring (246,227.15 USD). Conclusion: The clinical pharmacist responsible for TPN services plays an essential role in preventing TPN-related problems and avoid the unnecessary economic burden on the healthcare system. Expanding the role TPN clinical pharmacist is highly recommended for all TPN services to reduce the economic burden on healthcare system in Saudi Arabia.

}, keywords = {Economic outcome, Ministry of Health, Pharmacist Intervention, Saudi Arabia, Total Parenteral Nutrition}, doi = {10.5530/PTB.2019.5.36}, author = {Yousef Ahmed Alomi and Aisha Omar Fallatah and Faiz A. Bahadig and Amjad Ahmad AL Qahtani} } @article {153, title = {Economic Outcomes of Pharmacist Prescribing Total Parenteral Nutrition at Ministry of Health in Saudi Arabia}, journal = {Pharmacology, Toxicology and Biomedical Reports}, volume = {5}, year = {2019}, month = {September 2019}, pages = {S35-S39}, type = {Research Article}, chapter = {S35}, abstract = {

Objectives: In 2013, The General Administration of Pharmaceutical Care started the National Total Parenteral Nutrition (TPN) Program in Saudi Arabia. The pharmacist can provide neonates{\textquoteright} TPN services. In this study, we aimed to estimate the economic outcomes and cost avoidance in relation to pharmacist prescribing TPN. Methods: A total of 20 hospitals provide TPN services for neonates, pediatrics and adult patients. Cost avoidance stimulation in relation to the pharmacist prescribing and running neonates, pediatrics TPN services and replacement physician of a pharmacist as prescriber with adults TPN services. All costs were calculated by using US dollar currency. One-way sensitivity analysis was conducted for a list of discount prices and variety of wage cost with 10{\textendash}20\%. Results: The total annual estimated cost avoidance of pharmacist by providing TPN services for 20 hospitals for all types of patients was (1,569,865.40 USD) and with a discount of 10-20\%, it was (1,412,878.86-1,255,892.32 USD). Of those, the total annual estimated cost avoidance of pharmacist providing the TPN services for 20 hospitals for neonates was (562,027.40 USD) and with discount of 10-20\%, it was (505,824.66- 449,621.92 USD). The total annual estimated cost avoidance of pharmacist providing the TPN services for 20 hospitals for adults was (523,337.00 USD) and with discount of 10-20\%, it was (471,003.30- 418,669.60 USD). The total annual estimated cost avoidance of pharmacist providing the TPN services for 20 hospitals for pediatrics was (484,501.00 USD) and with a discount of 10-20\%, it was (436,050.90- 387,600.80 USD). Conclusion: The pharmacist prescribing TPN prevents high economic burden on the healthcare system at Ministry of Health. Expanding the role of a pharmacist in the nutrition support services with an emphasis on prescribing TPN services is highly recommended at healthcare institutions in the Kingdom of Saudi Arabia.

}, keywords = {Cost avoidance, Economic, Ministry of Health, Outcomes, Pharmacist, Prescribing, Saudi Arabia, Total Parenteral Nutrition}, doi = {10.5530/PTB.2019.5.35}, author = {Yousef Ahmed Alomi and Mona Awad Alanazi and Faiz A. Bahadig} }