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Home TPN patients who use specialty providers, have fewer complications.

Recently, Nutrishare sent a survey to home TPN patients asking them if their home care provider was a TPN specialty provider. When the results were reviewed those Home TPN consumers who used specialty providers said they received more clinical information from their pharmacists and had a lower rate of total complications than those who used a general provider. This paper will be presented in December at the Midyear Clinical Meeting of the American Society of Healthsystem Pharmacists in Las Vegas.

Patients from specialty home care providers feel pharmacists have a greater knowledge of nutrition support issues than pharmacists from a general home care provider.

John K. Siepler, Pharm.D., BCNSP, FCCP; Rod Okamoto, RPh, Tom Diamantidis, Pharm.D.; Reid A. Nishikawa, Pharm.D., BCNSP. Nutrishare, Inc. Elk Grove, CA.
Greg Killmeier, Pharm.D. BCNSP and Ian Robertson, Pharm.D. BCNSP receive their credentials as Board Certified Nutrition Support Pharmacists.

Nutrition Support Pharmacists address the care of patients who receive specialized nutrition support, including parenteral and enteral nutri­tion. The nutrition support pharmacist has responsibility for promoting maintenance and/or restoration of optimal nutritional status, designing and modify­ing treatment according to the needs of the patient. The nutrition support pharmacist has responsibility for direct patient care and often functions as a member of a multidisciplinary nutrition support team. Those who are granted certification in this specialty may use the desig­nation “Board Certified Nutrition Support Pharmacist” and the initials “BCNSP,” as long as certification is valid.

Both Greg and Ian passed an exam that is designed to evaluate a pharmacist’s knowledge and skill in nutrition support. There are less than 500 others worldwide who are board certified in nutrition support. Join us in congratulating both in their signifi­cant accomplishment.
Patients on home parenteral nutrition (HPN) receive their HPN from home care providers which are pharmacies that prepare and dispense intravenous products. Most of these providers dispense a variety of products in addition to HPN including antibiotics, intra­venous fluids, and respiratory medications. Thus, these providers can be considered general home care providers. Some providers specialize in specific areas such as respiratory therapy, hospice, pe­diatrics or HPN. These providers can be considered specialty home care providers. One way these specialty providers can make a dif­ference in patient care would be to reduce the frequency of HPN associated complications.

We sent a survey to HPN patients asking them to tell us if their home care provider specialized in HPN. In addition they were asked to tell us their opinion of the clinical information they re­ceived from their pharmacists and the number of HPN associated complications such as catheter infections, and catheter replace­ments occurring a one year period.

We believe this suggests that patients of home care providers who specialize in HPN have fewer complications than those who are using a general home care provider. It should be stated here that several of the HPN consumers who listed their HPN provider was a specialty provider did not use Nutrishare as their provider. There have been other reports of specialty providers (in areas other than HPN), having a lower complication rate than general providers, so this concept is likely not new. Despite this, we feel more work is needed in this area. Nutrishare will continue to strive to reduce the HPN associated complications in our consumers. This paper will be presented at the ASHP mid year clinical meeting in Las Vegas in December, 2007.

Nutrishare friends and family,

We can’t believe all that has hap­pened in 2007, from the Disney Cruise / Home TPN Education Conference in May, to the founding of the ‘Platinum Level’ of Oley Foundation support in July, followed up by the announcement of the Nutrishare / Oley Foundation Research Prize competition designed to stimulate research in the area of Home TPN.

Meanwhile, we continue to pro­duce our own research and product development, notably the new NuBox shipping system which is being rolled out as we speak. This, after an extensive pilot-testing project (thank you brave participants for your critical input).

Feel free to call us if you think of anything that could improve the care that you receive.


Rod Okamoto and Tom Diamantidis



 
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