4CPS-203 Evaluation of efficiency and clinical improvements of pharmaceutical interventions in a recently implemented social-sanitary centre

Background Social sanitary centres (SSC) are resources that coordinate healthcare and psychosocial care to groups of dependent patients such as elderly people, patients with mental disorders or with intellectual disabilities. Purpose To describe the process of implementation of a change in the supply of medicines in a SSC from a community pharmacy to a hospital pharmacy service. To detail the results obtained from the pharmaceutical interventions since the beginning of the process. To quantify the economic impact derived from this process. Material and methods A 5 month prospective study (December 2016 to April 2017) in a 110-bed long-stay SSC. In the first phase of the process, the pharmacotherapeutic guide and the medicines stock were proposed and agreed by the hospital pharmacist and the SSC medical department. Patients were admitted and their medication was electronically prescribed. The hospital pharmacist responsible for the centre performed various interventions such as: reviewing pharmacotherapeutic treatments, to answering medical and nursing questions, medication reconciliation or consultation with specialists. Results Seventy-nine drugs were added to the Hospital Pharmacotherapeutic Guide. The medication supply is done in unitary doses weekly, prepared individually and sent to the SSC in sealed bags and correctly identified. The pharmaceutical interventions were the following: 107 treatments were reviewed, 76 drugs were modified. These modifications were: therapeutic alternatives: two cases, therapeutic equivalent: 27 cases, dosage adjustment: five cases, suspension of a drug not indicated: eight cases, start of indicated drug: nine cases, suspension of drug contraindicated by age: two cases, suspension of drug contraindicated: one case, dose adjustment for renal failure: five cases. Medication reconciliation was implemented in 14 patients. 12 unjustified reconciliation errors were detected. Economic cost associated with the SSC in 3 months was €3626 and the cost of SSC medicines in the same period last year was €43,981, representing a monthly saving of €13 453. Conclusion The results obtained indicate that this implementation is a highly efficient intervention. The hospital pharmacist is indispensable in optimising the therapy in these patients, improving communication between professionals and guaranteeing an adequate and rational use of the medicines. In addition, this process represents an important economic saving. No conflict of interest