At a 1,000-bed teaching hospital in France, drug-related problems (DRPs) occurred less frequently in older patients with cancer cared for using the RECAP (phaRmaceutical care in Elderly CAncer Patients) model, researchers report. “The model was cost saving, confirming the value of implementing it in routine practice,” the authors conclude.
The RECAP intervention included pharmacist-provided comprehensive medication reconciliation and review at admission and discharge, identification of relevant DRPs and provision of optimization recommendations to prescribers, and at discharge, provision of patient education and communication with primary care providers. Peer review of the clinical significance of DRPs, changes in the polypharmacy rate, and a cost-saving analysis showed these results: “From January 2019 and August 2020, 201 patients were included (median age 80 [75–97] years), 68.7% with solid tumors. DRPs requiring optimization were identified in 70.9% of patients at admission (mean 1.7 DRP/patient) and 47.7% at discharge (0.9 DRP/patient). Most pharmacist recommendations (70.8%) were followed by prescribers, allowing the correction of 1.2 DRP/patient at admission and 0.7 DRP/patient at discharge. Half of resolved DRPs were rated as clinically significant. However, polypharmacy rate was not reduced at discharge. Cost comparison showed $7.2 avoided for $1 invested, with an estimated total net benefit of $354,822 (mean $1,766 per patient).”