What to expect when healthcare leaders and professionals have to mitigate costs amidst tightened compliance while ensuring patient safety and care satisfaction?
In this forecast, we present and analyze insights concluded from the most recent industry reports and scientific studies. For each clinical trend and challenge, we provide feasible solutions to benefit the clinical stakeholders. With the rising inevitables such as expanding pharmacists' responsibilities, growing PK/PD’s significance, higher expectations on quality care, and more studies to uncover individual parameters, we propose paths to be taken leading to an era of precision medicine.
Maximize support for pharmacists’ expanding role to address labor challenges
In recent analyses, both a soaring labor challenge led by new inflation highs and the expansion of pharmacy roles has surfaced. A recent McKinsey report states that clinical labor cost is expected to grow 6 to 10 percent in the next two years, accounting for nearly 40% of the potential extra healthcare cost at about $99 billion in the coming year.
Meanwhile, a predictive assessment by Wolters Kluwer argues that “Pharmacists and pharmacy technicians are often the most accessible healthcare providers in their communities. Both roles will continue to evolve in their scope of practice to include direct patient care that will only increase in the year ahead.”
The accompanying emergence of two observations is no coincidence. With their expertise to detect, resolve, and prevent medication errors and medication-related problems, pharmacists can reduce adverse drug events and hospital length of stay, and ultimately have a major impact on driving down preventable healthcare costs¹.
In conjunction with pharmacists’ role in public health settings related to the COVID-19 crisis, pharmacists have been at the forefront of yet another arduous battle. Persistent challenges in antimicrobial stewardship to which deterrents like inadequate time spent on comprehensive reviews of antimicrobial therapy² can be mitigated with more accessible evidence-based informative tools to optimize clinical outcomes.
Pharmacists are expected to continue protecting against antimicrobial resistance, which can be even more challenging with the added headwind of limited human resources and time constraints. In 2023, healthcare executives must acknowledge pharmacists' indispensable role and plan to distinguish their scope of work, including allocating resources such as clinical decision tools to optimize their workflow.
Related Resources: Technology-Driven Antibiotic Stewardship Improvement Cycle by PrecisePK
Meet Requirements in Care, Compliance, and Cost with Clinical Technology
Effective January 1, 2023, new and revised antibiotic stewardship requirements begin to apply to all Joint Commission accredited hospitals and critical access hospitals. The enhanced criteria are a testament to piloting healthcare into a more care-centric era. In relevance to such a matter, towards the end of 2022, FDA announced the continuance of the Model-Informed Drug Development (MIDD) Paired Meeting Program, indicating a heightened age for clinical efficiency and safety.
The motion of patient-centered care is here to stay, whether it is using model-informed methods in early development or in meeting individualized therapeutic targets such as employing Model-Informed Precision Dosing (MIPD).
In 2023, expect more clinical guidelines to emerge as a means to accelerate the delivery of patient care and safety. The pressure to adjust will weigh equally on decision-makers, private healthcare businesses, and healthcare professionals. Healthcare and pharmaceutical leaders must lead with visions, by proactively evaluating, adjusting, and working on viable improvements to stay prepared. With the right strategy, appropriately responding to compliance will set forth opportunities for positive change rather than scrambling to passively comply.
One common misconception is that with enhanced safety protocols in place comes increased costs due to increased manpower and extra time dedicated to each case. The reality is quite the opposite. For example, many studies show that investing in the prevention of adverse drug events emplaced is able to generate tremendous economic power. In contrast, the financial burden due to antimicrobial resistance can range up to $1 billion a year for the healthcare system, according to an international systematic review³.
Related Article: Optimizing Clinical Outcomes Through Rational Dosing Strategies: Roles of Pharmacokinetic/Pharmacodynamic Modeling Tools
Roots to Personalized Healthcare: More Pharmacy Studies to Account for Individual Factors
Despite the ample amount of time that has passed since the new vancomycin guideline came out in 2020, which strongly urged the use of AUC dosing, many institutions are still hesitant to implement new technology to support precision dosing:
This hesitation stems from the gap between academic research and clinical practice. Often time when the knowledge of a better method is obtained but no practical transformations are forged, dissonance develops and causes frustration. To encourage individualized care, leadership can take these small actions to better construct their overall objectives:
- Conduct a cost-benefit analysis to comprehend the full benefits of Bayesian-guided dosing
- Preliminary assessment on staff training and organizational-wide transition
- Starting a free trial with an effective and reliable MIPD software to consult customized services
On the flip side, pharmacokinetics research and studies are not doing justice to addressing clinical challenges. In particular, a recent study points out the negative impact of adverse drug reactions on women, shining light on the scarcity of data that distinguish sex differences in drug-bug-host relationships. The study found that “the dose required(for females) may be smaller than the dose calculated just by using body mass” and that “ subjecting females to medication doses that assume a proportional relationship with(male’s) body mass will result in overdosing”.⁴
Weight differences do not shape the scales to account for physiological traits, this fact drives complexity in obese populations as well. As explained by Jeffrey F. Barletta, BS, PharmD, FCCM, patients with obesity have a number of physiological changes happening to them, which can include increased liver mass, increased kidney weight, and glomerular filtration rate. These changes make organ function highly variable since organ size changes are not proportional to weight changes. As a matter of fact, calculating dosing weights faces its own challenges in selecting the best calculation method– body mass index(BMI), adjusted body weight, and lean body weight can result in very different size representations.
We are near the full bloom of personalized medicine, and the root of patient-centric care now, more than ever, lies in studies uncovering pharmacokinetic variables that address individual factors and in resources to properly leverage those findings. The aforementioned challenges and shortcomings warrant the support of clinical decision-making tools. Deploying bayesian-guided precision dosing software is a powerful way to ensure patient safety. Ready-to-use technology at the patient's bedside computes evidence-based individual dosing regimens within seconds, with extra drug factors accounted for. As more data is entered, local population characteristics can be collected to feed back into the Bayesian priors, reinforcing its predictive power.
Learn how PrecisePK’s industry-trusted Bayesian Therapeutic Drug Monitoring solutions can drive pharmacists' success.