Initiation of an outlet pharmacy in a busy urban emergency department: the first year

This article was originally published here

Am J Health Syst Pharm. May 21, 2022: zxac145. doi: 10.1093/ajhp/zxac145. Online ahead of print.


DISCLAIMER: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP publishes these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and edited, but are posted online prior to technical editing and author verification. These manuscripts are not the final version of the file and will be replaced by the final article (formatted according to the AJHP style and corrected by the authors) later.

PURPOSE: Discharge orders are an important aspect of care for patients seen in an emergency department (ED) setting and are used by providers to continue treatment of acute illness after patients leave ED or to prevent future exacerbations of chronic disease. The success of an emergency discharge and the medications prescribed depend on patient compliance. Adherence depends on patients’ ability to obtain prescriptions, which can be hampered by limited access to pharmacies and cost.

ABSTRACT: To address issues traditionally associated with medication non-compliance, an outlet pharmacy was implemented in a busy urban emergency department. The pharmacy began processing prescriptions on December 18, 2019, using a formulary aimed at providing commonly prescribed, high-risk medications. The pharmacy accepts insurance plans in addition to using 340B drug pricing program prices to provide affordable drugs to patients. During the first year of operation, 10,230 prescriptions were filled for 5,703 patients, representing 13% of all patients discharged during this period. Of the prescriptions filled, 35.4% were for products considered high-risk drugs, including epinephrine auto-injectors, insulin and antibiotics. More than 50% of these high-risk drugs were provided to patients through discounted cash prices. Pharmaceutical interventions were performed on 4.3% of prescriptions to address incorrect dosing, avoid the use of inappropriate antibiotics, and recommend alternative therapies.

CONCLUSION: The implementation of an exit pharmacy within the emergency department enabled more than 5,700 patients to be discharged with medication and represents a potential solution to problems related to medication non-compliance. Similar initiatives have the potential to improve access to medicines for a larger emergency population.

PMID:35596266 | DO I:10.1093/ajhp/zxac145