Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Oct 24;18(1):815.
doi: 10.1186/s12913-018-3627-3.

Clinical and economical impacts of guideline implementation by the pharmaceutical care unit for high cost medications in a referral teaching hospital

Afsaneh Vazin  1 , Iman Karimzadeh  2 , Razieh Karamikhah  1 , Zahra Oveisi  1 , Samaneh Mohseni  1 , Maryam Keykhaee  1 , Fatemeh Roshanfard  1 , Elaheh Sabet  1 , Asal Zargari-Samadnejad  1
Affiliations

Clinical and economical impacts of guideline implementation by the pharmaceutical care unit for high cost medications in a referral teaching hospital

Afsaneh Vazin et al. BMC Health Serv Res. .

Abstract

Background: Irrational drug use is a global health challenge in all healthcare settings, such as hospitals. This study evaluated the impact of an intervention by the pharmaceutical care unit on the use pattern of high-value medications and their direct costs in a referral hospital.

Methods: This interventional, prospective study was carried out in clinical wards of Namazi Hospital (Shiraz University of Medical Sciences) during six months from May 2015 to October 2015. Clinical pharmacists completed the checklists for albumin, intravenous (IV) pantoprazole, and IV immune globulin (IVIG), as three high-cost medications. When ordering these medications, the physicians were asked to complete the checklists. Then, trained pharmacists examined the checklists, based on the clinical and paraclinical conditions.

Results: The total number of administered medications and their relative cost decreased by 50.76% through guideline implementation; the difference was significant (P < 0.001). In addition, the direct cost of albumin and IV pantoprazole significantly decreased (55.8% and 83.92%, respectively). In contrast, the direct cost of IVIG increased by 40.9%. After guideline implementation, the monthly direct cost of all three medications decreased by $77,720 (55.88%). The all-cause in-hospital mortality rate did not change significantly due to the intervention. The median length of hospital stay was six and seven days, respectively in the pre- and post-intervention periods.

Conclusion: Based on the findings, implementation of guidelines by the pharmaceutical care unit caused a significant reduction in albumin and IV pantoprazole consumption and reduced their direct costs in a referral center in Iran.

Keywords: Albumin; Direct cost; Guideline implementation; Intravenous immune globulin; Intravenous pantoprazole; Pharmaceutical care unit.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The Institutional Review Board and the Medical Ethics Committee of the Shiraz University of Medical Sciences approved the study and written informed consent form was received from patients or their family members to participate into the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of pharmaceutical care unit guideline for the use of albumin, intravenous pantoprazole, and IVIG
See this image and copyright information in PMC

References

    1. Holloway K, Green T. Drug and therapeutics committees: a practical guide: World Health Organization; 2003. Available at: http://apps.who.int/medicinedocs/en/d/Js4882e/. Accessed 27 March 2017
    1. Maiti R, Bhatia V, Padhy BM, Hota D. Essential Medicines: An Indian Perspective. Indian J Community Med. 2015;40:223–232. doi: 10.4103/0970-0218.164382. - DOI - PMC - PubMed
    1. Rosenberg W, Donald A. Evidence based medicine; an approach to clinical problem-solving. BMJ. 1995;310:1122–1126. doi: 10.1136/bmj.310.6987.1122. - DOI - PMC - PubMed
    1. Schifalacqua MM, Shepard A, Kelley W. Evidence based practice: cost benefit of large sys implementation. Qual Manag Health Care. 2012;21:74–80. doi: 10.1097/QMH.0b013e31824d196f. - DOI - PubMed
    1. Marshall J, Finn CA, Theodore AC. Impact of a clinical pharmacist-enforced intensive care unit sedation protocol on duration of mechanical ventilation and hospital stay. Crit Care Med. 2008;36:427–433. doi: 10.1097/01.CCM.0000300275.63811.B3. - DOI - PubMed

MeSH terms

LinkOut - more resources