Survey of Pharmacy Services and Drug Usage in Victorian Public Hospital HITH Programs

Abstract

Objective: To determine the extent of pharmacy services and drug usage for Hospital‐in‐the‐Home (HITH) programs in Victoria.Method: In 1997, 42 Victorian hospital pharmacies with HITH services were surveyed by a questionnaire on services and drug usage over the previous six months.Results: Of the 29 hospital pharmacies which responded, 5 were not providing services, 16 provided 6‐month drug usage data and 15 provided drug expenditure data. Pharmacy staffing varied from a dedicated HITH pharmacist actively involved in patient management to no pharmacy involvement beyond drug dispensing. The range of pharmacy services provided included: preparation of intravenous additives; development of drug and administration protocols; care plans (including allergy and anaphylaxis procedures); supply of information regarding drug stability, storage and appliances, and consumer medicine information; patient counselling; therapeutic drug monitoring; and dosing advice.The data on drug usage and pharmaceutical expenditure was compromised by the inability of some pharmacies to identify HITH patients and inconsistent inclusion of non‐drug items. The range of drugs dispensed to HITH patients was broad, reflecting concurrent medical conditions and individual hospital practices. The most commonly dispensed parenteral drugs were ceftriaxone, cephazolin, dalteparin, flucloxacillin and vancomycin — reflecting the most common indications for HITH.Conclusion: HITH is an emerging alternative to inhospital patient management resulting in more patients being managed in the community. This creates an opportunity for hospital‐based health professional services to go beyond the hospital boundaries. Unlike the US, pharmacy services in HITH in Victoria are still evolving.