What is your role within your structure?
In my role as BPDO responsible pharmacist, I supervise all operations for the dispensation of oxygen for medical use at home. This covers the ordering, storage of equipment, delivery, but also the monitoring of patients receiving oxygen therapy, in collaboration with prescribing doctors and healthcare professionals working with the patient. More than ten years ago, we implemented monitoring of patient compliance in order to be able to adapt the treatment and thus reduce the waste of associated medical equipment, i.e. consumables. .
Why did you engage in such an approach?
The prescription of oxygen therapy is made by the doctor for patients suffering, for example, from respiratory failure in the case of pathologies such as chronic obstructive pulmonary disease, pulmonary fibrosis, etc. For our part, we carry out the implementation setting up equipment at home, informing patients and those around them about handling the equipment and respecting safety instructions related to oxygen, as well as maintenance. Check-up visits take place every three to four months for patients on oxygen therapy. In addition to oxygen bottles, we provide oxygen concentrators and all the equipment necessary for treatment: pipes, oxygen glasses, etc. It seemed essential to us to reduce the costs, not only financial, but also environmental, linked to the consumption of these health products and medical equipment, deliveries and various journeys.
Concretely, how does this work?
During his maintenance visit to the patient’s home, the technician reads the counter which indicates the number of hours during which the machine has been used. This information is integrated into software and, after reading the patient’s file, I compare it to the doctor’s prescription. If, for example, the patient has used the device for 5 hours while the prescription mentions 12 hours of use, I inform the prescriber who, depending on the severity of the pathology and the patient’s needs, can decide to adjust the treatment or, more rarely, propose “unfitting”. This makes it possible to adapt the oxygen equipment to the changing state of health of the patient and their lifestyle habits (need to walk, for example) and to limit waste through fairer dispensation of treatment.
What other measures have been put in place to promote the ecological transition?
During our home visits, we also ask the patient about the consumables delivered, such as oxygen glasses. If he has any stock left, we suggest he wait before restocking it, just as the community pharmacist asks his patient how many boxes of paracetamol remain in his medicine cabinet.
We have also undertaken to optimize our visits to patients’ homes. Oxygen therapy, sleep apnea, ventilation, suction… the needs of patients are not the same. We have created cohorts of patients and our planner builds rounds based on the maintenance requirements of the devices. We thus avoid unnecessary return trips to the homes of patients spread across several departments. We have therefore reduced fuel consumption and limited wear and tear on our vehicles.
The next objective is to equip our vehicles with a geolocation system. To deal with unforeseen events, such as troubleshooting a patient or setting up equipment for a new patient during the day, we will know in real time which technician to call in as quickly as possible and with the best level of skills. . The deployment of this system, planned for the end of 2024, should allow us to save kilometers and be more reactive during emergencies.
What advice would you give to a colleague to encourage them to implement measures in favor of the environment?
It takes patience and time! With the increase in under-dense medical areas and the workload of doctors, it is not always easy, for example, to quickly contact a practitioner to discuss a patient’s compliance. It also takes imagination and good knowledge of your sector to identify needs and embark on these approaches, which prove to be both beneficial for the environment and for public health.
