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November 2014 | Vol 3, Issue 5

A Special Thank You from Micromedex Solutions

As we celebrate the holiday season, we'd like to take a moment to thank you for your business. It's because of customers like you that we have so many reasons to be thankful.

We are committed to providing the evidence-based resources you rely on to inform and educate care decisions, including Clinical Decision Support (CDS) and Patient Education. To honor that commitment over the past year, we:

  • Bolstered our Patient Education content with enhanced imagery to improve patient understanding and comprehension
  • Improved clinician workflow and access to patient education at the point of care
  • Integrated clinical decision support and patient education in over 100 hospitals to support Meaningful Use
  • Added new surveillance hosting models to save hospitals valuable IT resources
  • Enhanced our enterprise-wide, real-time clinical surveillance solution to promote antimicrobial stewardship
  • Introduced professional consulting services to help hospitals better evaluate and prepare for the future of healthcare

Finally, as part of our ongoing commitment to maintain the standard of excellence in clinical decision support, enhancements are coming to Micromedex that will provide a more modernized user experience. 

We look forward to partnering with you in 2015 and continuing to provide you with solutions to improve healthcare quality, efficiency, and outcomes.

 

IN THIS ISSUE:


EXTRAORDINARY PERFORMANCE WITH A LOT OF HEART
WHAT'S NEW


CERNER PARTNERS WITH MICROMEDEX® SOLUTIONS FOR INTEGRATED CARENOTES®  PATIENT EDUCATION RESOURCES

 

TIPS & TRICKS


THE EBOLA OUTBREAK: COMPREHENSIVE AND CONSISTENT RESOURCES AVAILABLE ACROSS THE CARE CONTINUUM IN MICROMEDEX SOLUTIONS 
IN THE SPOTLIGHT


MICROMEDEX FEATURED IN HEALTHCARE GLOBAL TOP 10 TECHNOLOGIES SHAPING THE FUTURE OF HEALTH CARE
PRODUCT UPDATES


MICROMEDEX PRODUCT UPDATES
CLINICAL CONTENT UPDATES
      MICROMEDEX CLINICAL CONTENT UPDATES

 

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CLINICAL MATTERS

Extraordinary Performance with a Lot of Heart

Congratulations to the 50 Top Cardiovascular Hospitals by Truven Health Analytics™, an annual study that identifies the nation’s best providers of cardiovascular service. Hospitals do not apply, and winners do not pay to market their honor!

According to the results of this year's study, if all cardiovascular providers performed at the level of this year’s winners

  • Nearly 9,500 additional lives could be saved
  • Nearly 3,000 more bypass and angioplasty patients could be complication-free
  • More than $1.1 billion could be saved

Winners from the 50 Top Cardiovascular Hospitals also boast significantly higher inpatient survival rates (19-30 percent higher) and lower readmission rates (0.4 to 0.9 percent lower) than peers; and save as much as $4,000 per bypass patient.

The study, now in its 16th year, singled out 50 hospitals that achieved superior clinical outcomes in this critical area of hospital care. As is the case with the 100 Top Hospitals® study, the rigorous processes used to calculate and measure hospital service lines leverage industry-leading, risk-adjusted methodologies developed and maintained by Truven Health scientists over many years. These processes are widely regarded as the leading program for evaluating leadership impact in a hospital, as well as in evaluating quality indicators and efficiencies. 

The 50 Top Cardiovascular Hospitals study is available now! Order your customized benchmark report and comparative analysis today. Call 616-248-4645, or visit 100tophospitals.com.

Make it to the top! See what two multi-time winners of 100 Top Hospitals awards have to say about how their organizations are achieving cross-facility alignment, and how ongoing measurement is key to performance improvement.

Straight Talk From Your Peers: Achieving Operational Alignment

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WHAT'S NEW

Cerner Partners with Micromedex® Solutions for Integrated CareNotes®  Patient Education Resources

Truven Health Analytics recently announced a partnership with Cerner Corporation to make Micromedex CareNotes available to its ambulatory, acute care hospital, and health system customers. The evidence-based, health literacy standardized resources in CareNotes will be accessible directly from Cerner's EHR by clinicians and will include discharge instructions, general health summaries, pre-care, inpatient, laboratory, and medication education, among other tools and content, in multiple languages. Read more.

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TIPS & TRICKS

The Ebola Outbreak: Comprehensive and Consistent Resources Available Across the Care Continuum in Micromedex Solutions 

With the recent diagnoses of Ebola in the U.S., we'd like to remind you of the following patient care and education resources available in Micromedex Solutions. These evidence-based resources are essential in guiding preparedness and contingency planning.

Resources to Identify At-Risk Patients:

  • Using enterprise-wide real-time clinical surveillance, easily build an Ebola profile for early identification of patients who may have been exposed to the Ebola virus, for early isolation and intervention

Resources to Make Confident Care and Treatment Decisions:

  • In-depth and summary information on Ebola is available in Clinical Points within Micromedex Disease and Condition Management
  • Fully referenced, evidence-based articles in Drug Consults within Micromedex Medication Management, covering a wide range of Ebola topics, including experimental treatments and prevention
  • Toxicology information on the Ebola virus within Micromedex Toxicology to help poison control centers quickly identify, manage, and treat exposure, as well as monitor for clusters and outbreaks
  • Critical information on antiviral medications including information on viral hemorrhagic fevers in Martindale: The Complete Drug Reference

Resources to Educate Your Patients:

  • Educate your patients with comprehensive and consistent education available in Micromedex CareNotes. The following resources, specific to hemorrhagic fevers are available within Micromedex CareNotes: General Information, Inpatient Care, Discharge Care and AfterCare Instructions.

Resources to Reassure Your Community:

  • Be a trusted resource for your community with accurate information about Ebola, available on your website and in your patient portal, with Micromedex Consumer Health Education featuring SmartEngageTM
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IN THE SPOTLIGHT

Micromedex Featured in Healthcare Global Top 10 Technologies Shaping the Future of Health Care

Check out Top 10: Technologies Shaping the Future of Health Care by Healthcare Global and learn how Micromedex Medication Management is leading the charge!

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PRODUCT UPDATES

Redefine Your Micromedex Experience: The Final Countdown

As part of our ongoing commitment to maintain the standard of excellence in clinical decision support, enhancements are coming to Micromedex that will provide a more modernized user experience. Based on feedback from customers like you, we're rolling out enhancements that provide improved efficiency, streamlined searching, and faster access to the critical information you need and use the most.

On December 3, all Micromedex users will be converted to this new user interface. First, we want to give you a preview of what's coming

Register now for a live training session and get a first-hand preview of the changes. During each session, our dedicated Client Relations Managers will guide you through the intuitive and streamlined enhancements. You only need to register for one session - pick the time/date that works best with your schedule. Register soon to reserve your spot! For more information, contact our Customer Support Team at 800-525-9083.

 


 

New Micromedex CareNotes Release for Q1 2015 to Feature Time-Saving Enhancements

Coming soon, educating and engaging your patients will be even easier with Micromedex CareNotes. Available in Q1 2015, the CareNotes latest release will feature faster and easier access to the right patient education you need – right from the start. Stay tuned for further information and details, which will be available prior to this significant release.


RED BOOK Policy Update

Important Notice: RED BOOK Average Wholesale Price (AWP) policy has been revised to reflect changing market trends. We have updated our AWP policy to address the need to report Suggested Wholesale Price (SWP) for some manufacturers. For your reference, the complete AWP policy continues to be available on our website and the latest, recently revised version can also be accessed here.

We are committed to delivering the comprehensive, current, and accurate drug pricing you have come to expect in subscribing to RED BOOK. Please contact us if you have questions.

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CLINICAL CONTENT UPDATES

Selected New Drug Approvals - New Monographs and Patient Medication Instructions

U.S. Food and Drug Administration (FDA)

Abacavir/dolutegravir/lamivudine (Triumeq®): Approved to treat HIV-1 infection. Triumeq® is a once daily, single-pill regimen that includes the integrase strand transfer inhibitor dolutegravir, as well as the nucleoside reverse transcriptase inhibitors abacavir and lamivudine.

Canagliflozin/metformin (Invokamet™): Approved as the first oral fixed-dose type 2 diabetes combination therapy available in the US.

Cobicistat (Tybost®):Approved to treat HIV-1 infection. Cobicistat is administered once daily in combination with either atazanavir or darunavir.

Dulaglutide (Trulicity®):Approved as a once-weekly subQ injection to treat adults with type 2 diabetes. It can be administered alone or with other therapies and carries a boxed warning for causing C-cell tumors in rats.

Eliglustat (Cerdelga™): Approved for the long-term treatment of type 1 Gaucher disease in adult patients. Eliglustat is taken orally and works by inhibiting the metabolic process that forms fatty materials, thereby slowing fatty material production.

Elvitegravir (Vitekta®):Approved for use in treatment-experienced patients with HIV-1. Elvitegravir has been approved in Europe since 2013. Elvitegravir should be used concomitantly with background therapy that consists of an HIV protease inhibitor coadministered with ritonavir and another antiretroviral drug.

Empagliflozin (Jardiance®):Approved as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. The once-daily tablet can be taken alone or in combination with other type 2 diabetes therapies. 

Ferric citrate:Approved to treat hyperphosphatemia in patients with chronic kidney disease on dialysis. Ferric citrate is contraindicated in patients with iron overload.

Immune globulin/recombinant human hyaluronidase (Hyqvia): Approved to treat primary immunodeficiency in adults. Hyqvia offers a simpilified dosing regimen compared to existing therapies; however, it carries a black box warning for an increased risk for thrombosis.

Naloxegol (Movantik™):Approved to treat opioid-induced constipation in adults with chronic, non-cancer-based pain. Naloxegol is effective in patients with at least 4 weeks of opioid exposure.

Naltrexone hcl/bupropion hcl (Contrave®):Approved for chronic weight management in obese adults or overweight adults with an additional weight-related condition. Contrave® carries a black box warning for suicidal thoughts and neuropsychiatric symptoms.

Olodaterol (Striverdi® Respimat®):Approved to treat airflow obstruction in patients with COPD. Olodaterol, a long-acting beta agonist (LABA) once-daily inhalation spray, is not indicated to treat acutely deteriorating COPD or asthma and carries a boxed warning for an increased risk of asthma-related death with LABA use.

Oritavancin (Orbactiv™):Approved to treat adults with acute bacterial skin and skin structure infections (ABSSSI) caused by MRSA and other susceptible bacteria. The 3-hour IV infusion is given as a single dose.

Peginterferon beta-1a (Plegridy™):Approved to treat relapsing multiple sclerosis. Peginterferon beta-1a is dosed every two weeks and can be administered subcutaneously with the ready-to-use auto-injecting Plegridy™ Pen or a prefilled syringe.

Pembrolizumab (Keytruda®):Approved to treat patients with advanced or unresectable melanoma. Administered as an IV infusion every 3 weeks.

Suvorexant (Belsomra®):The first orexin receptor antagonist approved for insomnia. Suvorexant, a schedule IV controlled substance, was found to impair driving performance at higher doses, so all patients should be warned about activities that require mental alertness the following day.

 


European Medicines Agency Approvals (not already approved by the FDA) - New Monographs

Ataluren (Translarna): Indicated to treat Duchenne muscular dystrophy in ambulatory patients 5 years of age or older.  Ataluren is designated by the EMA as an orphan drug and is the first in its class to be approved for Duchenne muscular dystrophy.

Daclatasvir (Daklinza): Indicated to treat chronic hepatitis C virus (HCV) infection in adults.  Daclatasvir is considered breakthrough therapy for HCV and is to be used in combination with other drugs, including sofosbuvir or peginterferon alfa-2b with or without ribavirin.

 


New FDA-Approved Indications - Revised Monographs and Patient Medication Instructions

Adalimumab (Humira®): Expanded approval for treatment of moderate to severe Crohn disease to include use in patients 6 years of age or older who have not responded to other treatments. Approval for reducing signs and symptoms of moderately to severely active polyarticular JIA was also expanded to include patients 2 years of age or older; previously approved in pediatric patients 4 years or older.

Alglucosidase alfa (Lumizyme®): Now approved to treat infantile-onset Pompe disease in patients younger than 8 years of age. The FDA also eliminated the REMS after determining that alglucosidase alfa is comparable with Myozyme®, an FDA-approved alglucosidase alfa product for use in patients of all ages. 

Bevacizumab (Avastin®): Now approved in combination with paclitaxel and cisplatin or paclitaxel and topotecan, to treat patients with persistent, recurrent, or metastatic cervical cancer.

Coagulation factor XI recombinant (Rixubis)Expanded approval to include use in patients younger than 12 years of age. The drug is indicated for control and prevention of bleeding episodes, perioperative management, and routine prophylaxis in patients with hemophilia B. 

Eltrombopag (Promacta®): Now approved for use in patients with severe aplastic anemia in which immunosuppressive therapy has been ineffective.

Fluocinolone acetonide (Iluvien®): Now approved as the first long-term treatment for diabetic macular edema in patients who did not have a significant rise in intraocular pressure with corticosteroid treatment. 

Lacosamide (Vimpat®): Expanded approval to include monotherapy and single loading-dose administration for adults with partial-onset seizures. Loading doses should be given under medical supervision because of potential CNS effects. 

Methylnaltrexone bromide (Relistor®): Now approved for treatment of opioid-induced constipation in adults with chronic non-cancer-based pain.

 


New Off-Label Indications 

Apixaban for the treatment of venous thromboembolism (Class IIa, Recommended in most)

Rosuvastatin for the prophylaxis of radiographic contrast agent nephropathy (Class IIb, Recommended in some)

 


Other Significant Updates - Drug Content

START/STOPP Criteria -  Appropriate Use of Medications in Elderly Patients Drug Consult

A new drug consult was created to address START (Screening Tool to Alert doctors to Right Treatment) and STOPP (Screening Tool of Older Persons’ potentially inappropriate Prescriptions) criteria, which are published screening tools to assist in the appropriate use of medications in elderly patients.

Atorvastatin vs rosuvastatin: In the prophylaxis of postcardiac surgery atrial fibrillation, rosuvastatin and atorvastatin were similarly effective in patients undergoing isolated coronary artery bypass graft surgery (n=168). In Micromedex: see the Comparative Efficacy section of the Drugdex Evaluation monographs for each drug for additional details.

Enoxaparin dosage adjustment in burn patients: Added a new formula to calculate the enoxaparin dose for patients with moderate burn injuries. In Micromedex: see Dosage Adjustment section and summary and detailed enoxaparin monographs for additional details.

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