Conference: 2011 PH Professional Network Symposium
Release Date: 09.22.2011
Presentation Type: Abstracts
J. Brewer, RN, J. Priziola, PharmD, P. Gray, NP, S. Allen, DO
Beaumont Health System, Troy, MI
PURPOSE: The aim of this study was to survey intravenous (IV) and subcutaneous (SQ) prostacyclin patients in regards to patient medication safety practices.
BACKGROUND: IV and SQ prostacyclin therapies for pulmonary arterial hypertension (PAH) are high risk and can cause significant harm or death if not administered properly. Patients require considerable education in regards to these medications and the mechanisms used to administer the medication. Extensive education is provided to these patients by the PH team and their specialty pharmacy. Special attention is paid both to medication compliance and safety measures. Despite this education, observations were made by the PH team that demonstrated patient noncompliance. Therefore, a formal review was instituted.
METHOD: A total of nine (9) IV and SQ prostacyclin patients were verbally surveyed over a four month period (March through June 2011). Of those 9 patients, 3 were male and 6 were female. In regards to therapy, 4 were on IV epoprostenol, 2 on SQ treprostinil, and 3 on IV treprostinil. These patients had been on treatment ranging from 1 month to 8 years with ages ranging from 25-70. Patients were surveyed by the PH team at office visits, before cardiac catheterizations, and ancillary procedures to show evidence of compliance with the instituted safety measures: traveling with back up pump, back up supplies, back up medication, and proper medication storage.
RESULTS: Of the patients verbally surveyed, only 2% were compliant with the proper safety measures involved with IV and SQ prostacyclin therapy. The remaining 98% had traveled without back up medication, pumps, or had improperly stored medication. Various self-reported rationales were given ranging from "not being informed it was necessary" to "not believing it was necessary to travel with back up supplies".
IMPLICATIONS: A review of the results demonstrated a definite gap in what IV and SQ prostacyclin patients are taught and what is actually being practiced in regards to medication safety. These results indicate that further measures are required to insure compliance. Additional research includes the initiation of a 13 point self- care responsibilities contract with the goal of increasing compliance and holding patients accountable for their medication safety practices.