Medication stewardship using computerized clinical decision support: A case study on intravenous immunoglobulins.
Pharmacol Res Perspect
; 7(5): e00508, 2019 10.
Article
en En
| MEDLINE
| ID: mdl-31485333
ABSTRACT
Background:
Healthcare delivery organizations face increasing pressure to manage the use of medications in terms of safety, waste reduction, and cost containment.Objective:
To describe a computerized provider order entry (CPOE) system intervention to optimize use of a commonly ordered, high-cost therapeutic intravenous immune globulin (IVIG).Design:
Description of IVIG order configuration, medication use patterns, and subsequent order set configuration development in a CPOE system. Measurements IVIG orders were extracted from the CPOE system before and after the implementation of a specialty orderset to determine the indications for use, dosing, and duration of therapy. Orders were compared to a theoretical dosing schedule created from published evidence and data from a prior medication use evaluation.Results:
During 36 months before the implementation of the IVIG order set, 1965 IVIG orders were reviewed. The prescribed IVIG dose varied considerably from the expected dose (mean = -1.8, range = -4.9-1.5). In the 27 months after order set implementation, 848 IVIG orders were reviewed. The prescribed IVIG dose was closer to the expected dose (mean = -1.2, range = -3.9-2.6, P < .0001).Conclusions:
Order configuration processes are cumbersome and time-consuming, but can be streamlined to enhance a medication's usage in the healthcare system. A better understanding of institution-specific ordering patterns may facilitate more efficient and effective order configuration and optimize drug use.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Inmunoglobulinas Intravenosas
/
Sistemas de Entrada de Órdenes Médicas
Tipo de estudio:
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Pharmacol Res Perspect
Año:
2019
Tipo del documento:
Article
Pais de publicación:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
/
US
/
USA