How medication management saves costs

AT this time when there is a global economic retardation, which borderlines on a recession in some developed countries, and a simultaneous exponential increase in global healthcare cost, predominantly due to the pandemic, all cost-savings interventions should be explored.

In all healthcare expenditures, both at the individual and institutional levels, the budgetary allocation for medications is significant. Hence, medication management will not only optimize the use of such commodities for best therapeutic outcomes but also save cost.

Studies designed to measure the impact of pharmacists’ interventions to detect, resolve and prevent medication errors and medication non-adherence will establish that there are definite cost benefits to patient medication management, an evolving responsibility for clinical pharmacists in the advanced countries.

With respect to medication errors, clinical data collated over a period of eleven months from an out-patient health institution overseas, showed that there was 43.4 percent of medication errors due to therapeutic duplication and 25.7 percent due to drug interactions. The main drug classes highlighted in this group were antibiotic (24.23%), proton-pump inhibitors (13.27%) and analgesics (12.34%).

There were various responses to such interventions where 53 percent of the prescribers stopped the treatment, 21 percent changed the brand of the drug and 20 percent altered the frequency of the dosage. Noteworthy from an audit trail on patient records was that the revised directions were not documented; only verbal instructions were issued.

With respect to medication non adherence, data from studies showed that as high as 50 percent of the medications prescribed were not taken as directed due to various objections such as side effects experienced, affordability, pill burden, patient not being convinced on its effects or other barriers such as medication taste or pill size.

The dollar value of medication non-adherence is $100 billion in the United States. Worldwide this phenomenon is considered an economic burden, hence medication management by clinical pharmacists is gradually being appreciated as an asset and a win-win, reducing cost and enhancing the effectiveness of patient treatment in the process.

Hence special training for pharmacists focused on winning patients’ confidence for disclosure of critical information so interventions can be made for positive outcomes.

From another study done, the usual medical care cost compared with those services run by pharmacist showed cost savings to the value of US$647,024 by preventing emergency visits and hospital admission, especially when managing chronic diseases.

These trained resources are severely limited locally. Though piloted in a specialised department at the hospital, it has not become the universal practice. It is no secret that Guyana’s health system has been compromised by the migration curse to greener pastures over the decades, amplifying work load on the limited number of healthcare professionals who remained to serve their country.

But a succession plan must cater to this loss of our trained professionals to yield the favorable results discussed.

So, a critical review of

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THERE are many adjectives which can be used to describe fashionable clothing – stylish, conventional, avant-garde even whimsical – but who would have thought that ‘damaged’ would have been one of them.

Garments, particularly denim, which have been washed-out, frayed, ripped and otherwise ‘destroyed’ are now the popular look of fashion today.

And in a marketing move that is as adventurous as it is bold, this clothing is being sold to us for ‘top dollar’. When we buy our denim, the damage has already been done.

Over three decades ago, I sat opposite a young man on a New York subway train wearing denim which was slashed at the knees. At the time, all I could wonder was how on this winter’s day he was able to withstand the cold to his exposed knees and why he would even choose to wear pants he clearly tore himself.

Little did I know I was witnessing the revival of a fashion movement that would take the world by storm. Not only this, but also that people would pay for the privilege of having makers damage the clothing rather than do it themselves.

Upturning the whole concept of what is ‘proper’ clothing, ripped denim pants, skirts and even dresses have also moved out of the realm of the casual and are now being worn on more formal occasions.

This is in part due to the advent of spandex, which has revolutionised the fashion industry and when blended with denim, makes the formerly stiff and unyielding fabric body-fitting and comfortable.

Designers have been cashing in on something which probably began way back in poorer families where folks could not afford to throw away their denim even when it was worn out, often resorting to darning or patching the garment.

Now, in the age of trend, this sturdy fabric (originally portrayed by Levi Strauss as perfect for working men’s jeans) is ideal for the kind of ‘destruction’ which has conversely elevated it to the level of high fashion.

In fact, it is rare to see a denim item that does not show some evidence of damage, because even when bought in pristine condition the ‘unsuspecting’ garment is washed out, cut, torn and otherwise ‘mutilated’ by its owner, generally ending up looking like it has been around for years.

But perhaps the ‘writing was on the wall’ since the late 60s when bleached-out denim gave way to stone and acid-washed versions and the big brand names of the time – Levi, Wrangler and Lee – got involved.

Experts tell us that ripped jeans emerged in the ‘cultural punk movement of the seventies”, signifying rebellion. Sarah Rainey, writing for the British Daily Mail newspaper says, “…early punks tore apart consumer goods as an expression of their anger towards society, and denim became a key part of this political statement”.

Celebrity bands like the Sex Pistols and Iggy Pop began appearing on stage in ripped jeans and Madonna, Bananarama and others made the trend popular among women.

When fans started ripping their jeans at home manufacturers caught on as did designers and now the denim market, worth an estimated 1.5 billion pounds annually in the UK, is made up in large part by what is termed ‘distressed’ styles.

Celebrities around the world have been photographed in damaged jeans, paying as much as 725 pounds for Gucci designs, while ‘regular’ shoppers have been able to buy more affordable options.

And the difference in cost also has to do with the method of ripping – hand or laser- and the fact that today’s denim is thicker and stiffer and far more difficult to rip at home.

So, industry pundits explain that hand-ripping is more intricate and ‘requires individual workers to design, rip and finish each pair which can take several hours”.

But whatever the method, careful preparation goes into how and even where the garment is ripped. So, while it may appear haphazard, a lot more goes into making the damage than you may think.