Literature Review

The Dos and Don’ts of enhanced service contractsSpecialty Pharmacy Continuum; by Marcus A. Banks; 4/25/24 ... Any pharmacy that interacts with patients—an independent pharmacy, an ambulatory infusion clinic, a health system or specialty pharmacy—can enter an enhanced service contract with a pharmaceutical company. All services offered under these contracts should be documented, auditable and offered at fair prices. Before approaching the company about partnering, Mr. Suchanek advised understanding the distinction between basic and enhanced services. ... “Pharmacy leaders need to demonstrate that they are credible partners,” [David] Suchanek said [Executive Vice President for  Biotech & Specialty Services at D2 Solutions].

Cardinal Health, OptumRx break up Becker's Hospital Review, by Paige Twenter; 4/22/24Cardinal Health's pharmaceutical distribution contracts with OptumRx, a subsidiary of UnitedHealth Group, will not be renewed, the medical distributor said April 22.  The contracts, which mainly included non-specialty bulk shipments to Optum's mail dispensing sites, will expire in late June. In 2023, sales to OptumRx generated 16% of Cardinal Health's consolidated revenue. "Total sales to OptumRx generate a meaningfully lower operating margin than the overall pharmaceutical and specialty solutions segment," Cardinal said. McKesson Corp. won the contract, according to Bloomberg, which cited Evercore ISI. 

Governor Lamont announces $35.5 million in state grants to support nonprofit providers with capital improvement projects [$775 thousand to Connecticut Hospice]  State of Connecticut, Office of the Governor; 4/10/24 Governor Ned Lamont today announced that his administration is awarding approximately $35.5 million in state funding to nonprofit providers across Connecticut for capital improvement projects that support each respective organization in their mission of delivering services to some of the state’s most vulnerable residents. The grants are being released through the state’s Nonprofit Grant Program, which is administered by the Connecticut Office of Policy and Management. [The list includes:] ... "Branford – Connecticut Hospice: $775,000 (Pharmacy Improvements)"

Chicago area nurse gets 2 years in prison for stealing morphine from sick patientsCBS News TV 2, Chicago; by Acacia Hernandez; 4/4/24A northwest suburban nurse was sentenced in court on Thursday to two years in federal prison for stealing morphine from her patients, some of whom were terminally ill. Sarah Diamond, 31, of Woodstock, was accused of targeting the most vulnerable, including hospice patients living out their final days. In 2021, she removed liquid morphine from bottles that had been prescribed to at least five hospice patients and replaced it with saline. Prosecutors said she took the medication for her own personal use.

Antibiotics in end-of-life care NEJM Journal Watch, by Abigail Zuger, MD; 3/27/24Antibiotics often are considered to be among the gentler and more comfort-oriented interventions in end-of-life care, certainly far less aggressive than intubation or last-ditch surgery. ... Still, antibiotics do entail their own costs in the form of toxicities and need for intravenous access, and liberal antibiotic use reliably worsens institutional and community drug-resistance profiles. ... A new review was written for infectious disease consultants but contains specific suggestions that should interest both generalists and other subspecialists caring for dying patients. 

Nurse arrested after morphine, other stolen medical drugs seized in Owensboro14 News WFIE, by Aaron Chatman; 3/26/24 Eight suspects were arrested and facing numerous charges after a massive drug bust in Owensboro. That’s according to the Daviess County Sheriff’s Office, who says they opened an investigation after receiving dozens of tips about a drug trafficking operation at the home of Pamela Bartimus. Deputies say Bartimus was an employee of Hospice & Palliative Care of Western Kentucky and had been stealing medication at her job.

Frailty needs to be a factor in drug development, proposed guidelines suggest McKnights Long-Term Care News, by Kristen Fischer; 3/20/24A new report on strategies for geriatric drug development and assessment determined that drugs need to consider age as well as other factors that older adults face such as cognitive impairment, frailty and polypharmacy. This is according to the International Union of Basic and Clinical Pharmacology (IUPHAR) Geriatric Committee, which published the report. The strategies specifically focused on integrating frailty as a factor in drug development. The report, published in the Journal of the American Geriatrics Society earlier this month, includes 12 principles pertaining to frailty in reference to drug development. The recommendations include measuring frailty at the start of when a person goes on a drug they’ll likely take regularly.

Improvements in Interdisciplinary Communication Following the implementation of a standardized Handoff Curriculum: SAFETIPS (Statistics, Assessment, Focused Plan, Pertinent Exam findings, to Dos, If/Thens, Pointers/Pitfalls, and Severity of Illness) Cureus, by Shaefali Shandilya and Justen M. Aprile; 3/18/24 Handoffs between medical providers serve a crucial patient safety function. While most published literature on the topic studies the handover process among physicians, robust literature is available on interdisciplinary medical communication. Little is known about the downstream effects of effective physician handover on subsequent physician and nursing interactions. ...Results: Statistical analysis revealed significant post-intervention mean score increases of one full point in four categories, namely organization and efficiency, communication, content, and clinical judgment.

Antidepressant prescribing practices of pediatric palliative care providers Journal of Palliative Medicine, by Teresa Venta; 3/12/24 Objective: This study seeks to describe the antidepressant prescribing practices of PPC providers and describe their level of training and comfort in assessing for anxiety and depression and prescribing psychotropic medications. Conclusions: Limited training in assessing mental health concerns, prescribing, and managing psychopharmacology suggests an opportunity for more targeted education for pediatric PC providers regarding antidepressant prescribing practices.

Description and outcomes of a palliative care pharmacist-led Transitions of Care program J Palliat Med, by Connor McCormick, Mamta Bhatnagar, Robert M Arnold, Maria Felton Lowry; 3/6/24Background: Patients with palliative care needs are at high risk of medication errors during transitions of care (TOC). Palliative Care Pharmacist Interventions surrounding Medication Prescribing Across Care Transitions (IMPACT) program was developed to improve the TOC process from hospital to community setting for cancer patients followed by palliative care. Conclusion: Our pilot study demonstrates that integrating a pharmacist in TOC for seriously ill patients is feasible and valuable.

Subcutaneous patient-controlled analgesia in home-based palliative care: "It's as straightforward as pushing a button, right at my fingertips" J Pain Palliat Care Pharmacother, by Miguel Julião, Patrícia Calaveiras, Eduardo Bruera, Paulo Faria de Sousa; 2/26/24Subcutaneous patient-controlled analgesia (SCPCA) in home-based palliative care is a potentially valuable option for providing effective pain relief to some patients, particularly when conventional analgesic approaches prove ineffective or are refused.

CMS issues additional guidance on program to allow people with Medicare to pay out-of-pocket prescription drug costs in monthly paymentsCMS.gov; 2/15/24The Inflation Reduction Act’s Medicare Prescription Payment Plan will allow people to pay Medicare Part D out-of-pocket costs over the course of the year starting in 2025. [On February 15th,] the Centers for Medicare & Medicaid Services (CMS) released the second part of draft guidance for the Medicare Prescription Payment Plan that outlines requirements for Medicare Part D plan sponsors, including outreach and education requirements, pharmacy processes, and operational considerations, for the program’s first year, 2025.