Document Detail


Interventions to curb the overuse of Acid-suppressive medications on an inpatient general medicine service.
MedLine Citation:
PMID:  20221325     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: We conducted a study to measure the impact of three sequential levels of intervention on prescribing patterns of acid-suppressive medications (ASMs) on an inpatient internal medicine service at a university hospital.
METHODS: THIS RETROSPECTIVE REVIEW COMPARED PRESCRIBING PATTERNS ON FOUR DIFFERENT TIERS: a phase 1 study, conducted one year before the phase 2 intervention study; and three phase 2 interventions. Each group was assessed for the percentage of all patients receiving ASMs and the percentage of patients receiving these drugs with an inappropriate indication. The three phase 2 studies are described in this article.
RESULTS: Intervention A (a beginning-of-year lecture to all interns) was not enough to decrease total in-hospital use of these medications, compared with the phase 1 historical controls (62% vs. 66%, respectively); however, it did decrease the rate of inappropriate use from 59% to 37% (P < 0.001). When Intervention B (an early-in-the-month rotation "reminder lecture") was added, the volume of agents used was significantly reduced to 53% (P = 0.025) and the number of inappropriate prescriptions was reduced to 32% (P < 0.001), compared with rates in phase 1. Finally, when Intervention C (a clinical pharmacist making rounds with the health care team on most post-call days) was added to Interventions A and B, the total volume of drug use in the hospital declined to 53% (P = 0.025) and the number of inappropriate prescriptions fell to 19%, compared with rates in phase 1 (P < 0.001).
CONCLUSION: Providing educational lectures for interns was helpful in curbing the inappropriate prescribing of ASMs, but the benefit was augmented when a clinical pharmacist was added to the team.
Authors:
Randolph E Regal; Amanda D Osta; Vikas I Parekh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  P & T : a peer-reviewed journal for formulary management     Volume:  35     ISSN:  1052-1372     ISO Abbreviation:  P T     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9015516     Medline TA:  P T     Country:  United States    
Other Details:
Languages:  eng     Pagination:  86-90     Citation Subset:  -    
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