Improving health and the bottom line with ASP
Christopher Mangione, R.Ph., MBA
Nearly 2 million Americans are sickened every year due to antibiotic resistance and inappropriate use of antibiotics has contributed to $21B–$41B in rising healthcare costs.1 To help curb this trend, antibiotic stewardship programs are becoming a top priority among pharmacy leaders.
McKnight's has reported on the Centers for Medicare & Medicaid Services proposal that included requirements for long-term care facilities (LTCFs) to establish ASPs. For LTCFs, ASPs offer benefits ranging from improved patient health and public safety to cost savings. As a partner to LTCFs, it is important to understand the underlying causes of antibiotic resistance, the current and future impact on your patient population, and the role your pharmacy can play in supporting an effective ASP.
Antibiotic resistance on the rise
More than 4 million Americans currently reside in LTCFs and it is estimated from 50% to 70% receive some type of antibiotic treatment every year.2,3 Although antibiotics play an important role in improving patient health, some drugs are unnecessarily or inappropriately prescribed and we are seeing an increase in antibiotic resistance in the treatment of issues like urinary tract infections, diarrheal diseases and staph infections. Additionally, patients are suffering adverse effects leading to longer, more expensive hospital stays.
Opportunities for your pharmacy
The population of those 65 years and older is nearly expected to double by 2050.4 LTC pharmacies are well positioned to help enhance the quality of care for seniors through the safe use of medications. In addition, changes across the continuum of care including new performance-based payment models mean that hospitals will continue to look toward LTCFs to help improve patient outcomes and reduce readmissions. As a result, long-term care pharmacists will continue to play an important role in helping to ensure that the right medications are delivered to the right patients at the right time.
Your role in antibiotic stewardship
For some LTC pharmacies, antibiotic stewardship tends to focus on obtaining accurate culture and sensitivity data along with stop dates, which are the basis for state regulatory review.5 At the same time, there is a significant emphasis on antibiotic utilization. This typically includes ensuring the appropriate therapy and dosage of oral antibiotics. Other ways your pharmacy can help reduce drug resistance and support ASPs include:
• Offer education and counseling — Provide your staff with infectious disease training and consider counseling customers on appropriate antibiotic use and adherence.
• Open lines of communication — Have dedicated personnel responsible for communicating directly with patients and their caregivers to ensure the proper handling, storage and use of medications.
• Monitor and analyze antibiotic usage — Utilize technology to track antibiotic usage and resistance along with your drug spend. This information will allow you to better identify trends and opportunities for improvement.
• Establish policies and protocols — Based on the information and best practices that you have collected, develop clear guidelines for diagnosis and treatments.6
According the CDC, better infection control and antibiotic use will save lives, improve care and reduce medical costs. LTC pharmacies can help lead this critical effort by supporting the successful implementation of ASPs.
Christopher Mangione, R.Ph., MBA, is the senior director, national accounts, at McKesson Alternate Site Pharmacy. For more information, email firstname.lastname@example.org or visit www.McKessonAlternateSiteRx.com
About the Author: Christopher Mangione, R.Ph., MBA, has more than 25 years of healthcare experience and currently serves as the Sr. Director National Accounts for the McKesson Alternate Site Pharmacy business. In this role, he partners with key stakeholders on solutions that help alternate site pharmacy customers grow their business, increase efficiency and improve their financial outcomes. Previously, he served as the VP Clinical/Utilization Management at PharMerica.
1 2013 Antibiotic Resistance Threats in the U.S., CDC, January 22, 2013
2 Get Smart for Healthcare — Antibiotic Use in Nursing Homes, CDC, January 22, 2015
3 Nursing Homes and Assisted Living (Long-Term Care Facilities), CDC, January 22, 2015
4 Projected Future Growth of the Older Population, Department of Health and Human Services, Administration on Aging, June 23, 2010
5 State Operations Manual Appendix PP — Guidance to Surveyors for Long-Term Care Facilities, Centers for Medicare and Medicaid Services, February 6, 2015
6 Get Smart for Healthcare — Core Elements of Hospital Antibiotic Stewardship Programs, CDC, January 22, 2015