RESUMEN
Purpose: The common practice of changing patients to daptomycin for outpatient parenteral antibiotic therapy (OPAT) can increase inpatient daptomycin use and impact inpatient pharmacy expenses. The purpose of this study was to quantify the additional inpatient antibiotic expenditures associated with changing patients from vancomycin to daptomycin for OPAT. Methods: This study examined patients who were discharged from January 1, 2018 to June 30, 2019. Patients were included if they were ≥18 years old, transitioned from vancomycin to daptomycin prior to discharge, and were cared for by the Infectious Diseases OPAT program. Patients switched to daptomycin for therapeutic reasons were excluded. A cost analysis evaluating the vancomycin regimen prior to changing to daptomycin and the daptomycin doses given prior to discharge and during readmissions for the first 6 weeks after discharge was performed using Wholesale Acquisition Costs. The primary outcome was the inpatient antibiotic expense associated with changing to daptomycin for OPAT. Results: Sixty-eight patients met study criteria. The mean number of inpatient doses of daptomycin administered prior to discharge was 4.3. Twelve patients were readmitted and received a mean of 5.3 additional doses. The estimated cost difference between the inpatient daptomycin doses and equivalent vancomycin therapy was $2647 per patient. Limiting patients to only 1 pre-discharge dose of daptomycin would reduce this cost difference to $926 per patient. Conclusion: Switching from vancomycin to daptomycin for OPAT can be associated with substantial inpatient pharmacy costs. These excessive costs can be mitigated if only 1 dose of daptomycin is given before discharge.
RESUMEN
Pharmacy school applications have steadily declined over the past several years. Thus pharmacy schools are not only searching for effective means to increase enrollment of qualified candidates, but are also focusing on the development of programs to improve academic performance and retention of enrolled students. To address the needs of struggling first-year pharmacy students enrolled in an Integrated Biological Sciences (BSI) course, an academic performance enrichment program (APEP) was developed. The program was designed to improve academic success by engaging low-performing students with the aims of improving their time management skills, study skills, metacognition, and understanding of BSI course material. The APEP consisted of structured tutoring sessions twice per week, which were required for all students with a course grade ≤73.5% at any point during the semester. To assess program effectiveness, performance improvement on BSI exams by the APEP students were compared with that of non-APEP students in the same class and to those in the previous 3 yr. Student perceptions of the program were also evaluated via an online survey. The APEP was deemed effective in that a greater percentage of students were able to improve their exam scores and to a greater extent by attending the APEP sessions compared with non-APEP students in the same class and with low-performing students in previous years when the APEP did not exist. Furthermore, APEP students believed the program was effective in meeting its aims. In conclusion, the APEP was effective in improving academic performance of low-performing students in BSI.