Natalie Paul, PharmD, BCPS, VP of Clinical Services for CPS, has co-authored an article – A Retrospective Review of an Inhaler to Nebulizer Therapeutic Interchange Program Across a Health System – published in the Journal of Pharmacy Practice, May 21, 2022.
Saint Alphonsus Health System (SAHS) hospitals implemented a metered dose inhaler (MDI) to nebulization therapeutic interchange program in which all orders for albuterol/ipratropium and inhaled corticosteroid/long-acting beta agonists (ICS/LABA) MDIs were therapeutically interchanged to nebulizers by the pharmacy.
Dr. Paul teamed with Megan E. LaCrone, PharmD, and Natalie Buening, PharmD, BCPS – both from St. Alphonsus Regional Medical Center in Boise, ID – to examine the primary outcome measure and assess the percentage of albuterol/ipratropium and ICS/LABA inhalers therapeutically interchanged to nebulized solutions.
Secondary outcomes included assessment of readmission rates, the percentage of patients discharged with the appropriate MDI, and a financial analysis of the implementation of the therapeutic interchange program.
The study was conducted between October 15, 2019 and February 15, 2020. It included adult patients with a history of asthma or COPD admitted to one of the SAHS hospitals with an order placed for ipratropium/albuterol, fluticasone/salmeterol, mometasone/formoterol, or budesonide/formoterol MDIs. Patients who were presumed to have or tested positive for COVID-19 were excluded from the study.
The first phase of implementing the SAHS inhaler to nebulizer therapeutic interchange program was operationally and clinically successful.
The MDI to nebulized solution interchanges saved almost $14,000 in medication costs in the sample population. The program is projected to continue to reduce medication waste and provide cost savings for SAHS.
Read the full article here: