San-Kuei Huang1, Pen-Jen Wang2, Wen-Fuh Tseng2, Fei-Kai Syu3, Miaw-Chwen Lee4, Ru-Liang Shih2, Mao-Ting Sheen5, Michael S Chen6. 1. National Health Insurance Administration, Ministry of Health and Welfare, Taiwan. 2. Medical Review and Pharmaceutical Benefit Division, National Health Insurance Administration, Ministry of Health and Welfare, Taiwan. 3. Division of Clinical Pharmacy, Department of Pharmacy, China Medical University Hospital, Taiwan. 4. Department of Social Welfare, National Chung Cheng University, Taiwan. 5. Taipei Division, National Health Insurance Administration, Ministry of Health and Welfare, Taiwan. 6. Department of Social Welfare, National Chung Cheng University, Taiwan. Electronic address: aping.chen@msa.hinet.net.
Abstract
OBJECTIVES: The aim of this article is to present the preliminary impact of a medication monitoring program, PharmaCloud, in Taiwan and analyze the embedded factors that have contributed to the performance thereof. This article also compared PharmaCloud with similar international programs in order to draw lessons learned. METHODS: The five domains of the RE-AIM framework - reach, effectiveness, adoption, implementation, and maintenance - were examined using qualitative and quantitative data. A difference-in-differences model was applied to analyze the quantitative impact of PharmaCloud on drug utilization and drug expenses. The qualitative impact was evaluated by document analysis based on field reports from the participating medical institutions. RESULTS: Reach and adoption: although all of the major hospitals adopted PharmaCloud and some of the hospitals had high inquiry rates, more time and incentives are needed to raise the overall inquiry rate. Effectiveness: during the study period of 3 months, the number of medications per prescription declined in the intervention group was 0.15 more than that of the general population, and the drug expense per person declined in the intervention group was NT $567 (US $18.9) more than that of the general population. The potential savings could be between 2% and 5% of the total pharmaceutical expenditure. Medication duplication was found to have decreased more in the intervention group. IMPLEMENTATION: a variety of innovations in care delivery are being developed in which the pharmacists play a more significant role. Maintenance: the embedded National Health Insurance would lend strong support for PharmaCloud to grow and thrive. CONCLUSION: PharmaCloud owes its effectiveness to the embedded National Health Insurance (NHI) program, which is universal and provides a comprehensive benefit package including more than 16,000 prescription drugs. An effective medication program is one that operates under the principle of universality and comprehensiveness, facilitates innovations, and has a substantial level of interoperability with the intra-hospital health information systems.
OBJECTIVES: The aim of this article is to present the preliminary impact of a medication monitoring program, PharmaCloud, in Taiwan and analyze the embedded factors that have contributed to the performance thereof. This article also compared PharmaCloud with similar international programs in order to draw lessons learned. METHODS: The five domains of the RE-AIM framework - reach, effectiveness, adoption, implementation, and maintenance - were examined using qualitative and quantitative data. A difference-in-differences model was applied to analyze the quantitative impact of PharmaCloud on drug utilization and drug expenses. The qualitative impact was evaluated by document analysis based on field reports from the participating medical institutions. RESULTS: Reach and adoption: although all of the major hospitals adopted PharmaCloud and some of the hospitals had high inquiry rates, more time and incentives are needed to raise the overall inquiry rate. Effectiveness: during the study period of 3 months, the number of medications per prescription declined in the intervention group was 0.15 more than that of the general population, and the drug expense per person declined in the intervention group was NT $567 (US $18.9) more than that of the general population. The potential savings could be between 2% and 5% of the total pharmaceutical expenditure. Medication duplication was found to have decreased more in the intervention group. IMPLEMENTATION: a variety of innovations in care delivery are being developed in which the pharmacists play a more significant role. Maintenance: the embedded National Health Insurance would lend strong support for PharmaCloud to grow and thrive. CONCLUSION: PharmaCloud owes its effectiveness to the embedded National Health Insurance (NHI) program, which is universal and provides a comprehensive benefit package including more than 16,000 prescription drugs. An effective medication program is one that operates under the principle of universality and comprehensiveness, facilitates innovations, and has a substantial level of interoperability with the intra-hospital health information systems.
Authors: Marina Kawaguchi-Suzuki; Miranda G Law; Jennifer Prisco; Kathleen Head; Lei Fu; Tetsuro Yumoto; Junzo Kamei; Mihi Yang; Kuei-Ju Cheng; Michael D Hogue Journal: Am J Pharm Educ Date: 2019-05 Impact factor: 2.047
Authors: Kung-Chuan Hsu; Hai-Lin Lu; Chi-Ming Kuan; Jin-Song Wu; Chyn-Liang Huang; Pu-Hua Lin; Damien Trezise; Tzu-Chueh Wang Journal: Int J Environ Res Public Health Date: 2021-01-22 Impact factor: 3.390