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Evaluate the Effectiveness of Fluoxetine 90mg Administered Every Week and Every 2 Weeks in Nursing Home Residents Terrance Bellnier, RPh, MPA, Shyam Karki, PharmD, MA, Tulio Ortega, MD, Adam Decatur, PharmD, Department of Pharmacy Practice ABSTRACT: PMH 6
Cost Data
RESULTS: Effectiveness data
DISCUSSION
Purpose: To evaluate the effectiveness of fluoxetine 90mg every week/every 2 weeks
in elderly nursing home residents.
There was no statistically significant difference in Method: Twenty patients were randomly selected who had been stabilized on 20mg Geriatric Depression Scale scores before or after the fluoxetine daily for 3 months were switched to fluoxetine 90mg every Week. An switch for either the fluoxetine 90mg weekly group additional 20 patients were randomly selected who had been Stabilized on 10mg or fluoxetine 90mg every 2 week group. GI tolerabilty fluoxetine daily for 3 months and switched to fluoxetine 90mg every 2 weeks. The was comparable with both fluoxetine 90mg weekly and Geriatric Depression Scale (GDS) was administered to all patients to assess Weekly Every 2 weeks
every 2 week dosage when compared to respective effectiveness 1 week before and 6 weeks after the switch. Costs were calculated as drug acquisition cost, nursing time and pharmacy time. Generic fluoxetine was used in daily fluoxetine dosage. The total two week costs for both cases for 3 months prior to switching to fluoxetine 90mg weekly.
fluoxetine 90mg vs fluoxetine 20mg daily was $39.72 vs Results:
$46.06, P,.05. The total two week costs for fluoxetine Subject characteristics: Fluoxetine weekly group/Fluoxetine every 2 week group 90mg every 2 weeks vs fluoxetine 10mg daily was Respectively: Age: 81 + 8/82 + 9, Sex: 14 females/ 8 females, Ethnicity: 6% AA, 1% $19.03 vs $45.22, P <.05. The significant cost difference Hispanic, 7% AA, 1% Hispanic. Effectiveness: There was no statistical significant was associated with nursing and pharmacy time related difference in GDS scores before or after the switch for either the fluoxetine 90mg Fluoxetine 20mg qd
Fluoxetine 90mg weekly
to the administration and dispensing of medication that weekly group or the fluoxetine 90mg every 2 weeks group. Costs: Costs ($) for a two requires daily dosing vs. weekly dosing. Nursing and week period before and after the switch were as fol ows: Fluoxetine 90mg weekly Fluoxetine 10mg qd
Fluoxetine 90mg every 2 weeks
pharmacy costs were determined by a time study based before/ after respectively: Drug acquisition costs- 1.68/33.38, nursing costs- on 200 observations of tasks associated with 21.00/3.00, pharmacy costs- 23.38/3.34, Total-46.06/39.72, P <.05. Fluoxetine 90mg every 2 weeks before/after respectively: Drug acquisition costs- 0.84/16.99, nursing administering and dispensing medication.
costs- 21.00/1.50, pharmacy costs-23.38/3.34, total- 45.22/19.03, P < .05. Conclusion:
This suggests that fluoxetine 90mg weekly and fluoxetine 90mg every 2 weeks are CONCLUSION
effective in nursing home patients. The costs associated with the administration of medication may be a more significant factor to consider when evaluating cost Our results suggest that fluoxetine 90mg weekly and fluoxetine effectiveness. Our findings are limited by the small sample size and did not account for other costs due to adverse effects, noncompliance, and medication errors.
RESULTS: Cost data
90mg every two weeks are cost effective in nursing home residents. Fluoxetine 90mg weekly was found to be more cost DEMOGRAPHICS
effective than generic fluoxetine (20mg and 10mg) administered daily. The reduction of the number of doses that need to be administered to a nursing home patient has a significant impact on total medication management costs. This strategy could be applied to comparing medications from other classes of drugs that require single or multiple daily administrations. In addition, we found that Fluoxetine 90mg weekly and every two weeks was well tolerated and compliance was significantly improved when compared to the daily administration of fluoxetine. Our findings are limited by the smal sample size and did not account for other costs due to adverse effects, non-compliance, and medication 40.0%
30.0%

errors. These factors that should be positively influenced by reducing the number of doses administered. References:Shaw J et al Long Term Health Management, 2001;29-31 Glasgow RE Patient Compliance in Medical Practice and Clinical Trials.NY,NY Raven 1991Kaplan JM J. Clin Psych 1997;58 (suppl 7)31-35 Presented at ISPOR Annual International Meeting, Washington DC May 2003 Doses taken
Doses missed

Source: http://wings.buffalo.edu/psychoPharm/pdf/prozac_weekly_ispor.pdf

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