Presentation on theme: "Use of Telephone Prescription Renewal Requests with Order Checks to Systematically Assess Renal Dosing Jamie Young, Pharm.D.; Bonnie Dugoni, Pharm.D.;"— Presentation transcript:
Use of Telephone Prescription Renewal Requests with Order Checks to Systematically Assess Renal Dosing Jamie Young, Pharm.D.; Bonnie Dugoni, Pharm.D.; Julio R. Lopez, Pharm.D.; Phebe Kwon, Pharm.D.; Jeanene Nehira, Pharm.D. VA Northern California Health Care System (VANCHCS) Martinez, CA
Background: Evaluate the clinical impact of telephone care program pharmacists reviewing medication dosing for patients identified by the order check s. Neither VISTA nor CPRS provide drug- specific renal dosing warnings at the point of prescribing or prescription verification by the pharmacist.
Renewal Order Check Auto Renewal Requests with Order Checks PATIENT PRESCRIPTION Last, First name *Est. CrCl: 27.1 (CREAT: 2.55 mg/dL [H] 9/29/10 1:02:29 pm BUN: 32 mg/dL [H] 9/29/10 1:02:29 pm) [Est. CrCl based on modified Cockcroft-Gault equation using Adjusted Body Weight (if ht > 60 in.)] Estimated CrCl if less then 50 ml/min (CPRS Order Check *Estimated CrCl if <50 is enabled at the system level) (VANCHCS – Audio renewal program launched mid September 2010)
Findings: Between 9/13/10 and 10/28/10, 359 patient profiles were reviewed. Forty-one dosing interventions were made; two of which required discontinuation of therapy. Allopurinol > Gabapentin > Ranitidine Alendronate > Colchicine > Losartan, Acyclovir, Famciclovir, Sotalol, Valgancyclovir, Tramadol, Probenecid, Metformin, Hydrochorthiazide, Ciprofloxacin, NSAIDS
Contact Information: Jamie Young, Pharm.D. Manager, Pharmacy Telephone Care Program VANCHCS – Muir Road Martinez, CA