Clinical pharmacy key performance indicators (cpKPIs) as determinants of resource stewardship of Nirmatrelvir/Ritonavir (Paxlovid) (Poster).

Abstract

Background: Our clinical pharmacy Hospital at Home team, runs a novel, clinical pharmacy-led COVID Therapies Service to determine patient suitability for Pharmaceutical Benefits Scheme (PBS) or National Medicines Stockpile (NMS) stock. Barriers to access for Paxlovid include commencement within five days of symptom onset, requiring rapid clinical pharmacy review for drug interactions. Multidisciplinary Team collaboration occurs throughout the process. cpKPIs were captured via a three-month data collection survey, to assess the volume and value of resources currently being utilised. Action: Process mapping was used to describe cpKPIs that were then used to collect raw data which was recorded in Excel. cpKPIs fell into the three categories; medication safety, pharmacist prescriber interactions and patient satisfaction. The first cpKPI category tracked Targeted Medication Therapy Review (TMTR), including Drug Interaction Check (INT) to determine Complexity Rating (CR). Pharmacist and Prescriber Consultation (PCP), Prescriber Uptake of Pharmacist Recommendations (PUPR) with resultant Medication Action Plan Provision (MAPP) and Pharmacy Progress Note (PNR) comprised the second category. The third category recorded Patient Counselling on treatment Day-1 and Day-5 (PC1, PC5), Pharmacy Technician Coordination of Supply (PTCS) and Patient Satisfaction Rating (PSR). Evaluation: Each cpKPI contained data that quantitatively measured the degree of internal and external conditions inherent in the current model of care. Preliminary data suggests that most patients have a high CRX requiring more than 5 instances of INT in order to determine TMTR and MAPP post PCP. Most consultations were provided using Telehealth and the PSR provided by patients neared 100% which bodes well for uptake of the model by other health services. Discussion: The onset of the COVID-19 pandemic forced many health services to rapidly implement changes to care delivery, putting stress on available resources. Our system of cpKPI monitoring, is applicable to departments requiring performance, quality and safety metrics.