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Article: Antiulcer drug prescribing in hospital successfully influenced by 'immediate concurrent feedback'

TitleAntiulcer drug prescribing in hospital successfully influenced by 'immediate concurrent feedback'
Authors
Issue Date1998
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/clpt/index.html
Citation
Clinical Pharmacology And Therapeutics, 1998, v. 64 n. 5, p. 569-574 How to Cite?
AbstractObjective: To determine whether immediate concurrent feedback (ICF) focused on inpatient omeprazole prescribing achieved more rational and cost- effective antiulcer drug prescribing and usage. Methods: In a 1400-bed teaching hospital, an audit (by specially trained personnel) was conducted to monitor inpatient prescribing of omeprazole (1) in preference to H 2- antagonists and other drugs according to agreed criteria (Helicobacter pylori eradication, severe reflux esophagitis, rapid ulcer healing deemed urgent because of severe symptoms or complications, high-dose steroid therapy of ≥30 mg/day prednisolone) and (2) appropriateness of intravenous dosing (oral route not feasible or contraindicated). After baseline monitoring for 1 month, followed by relevant antiulcer drug therapy education, ICF was instituted for 1 year. This entailed explanatory memoranda requesting a change in prescribing issued to the respective medical teams of patients whose omeprazole prescription did not 'conform.' The main outcomes of the study were omeprazole prescription numbers per month and the proportion conforming, defined daily doses of antiulcer drugs used and corresponding expenditures, and pertinent antiulcer drug utilization data from 9 other local hospitals. Results: Baseline omeprazole prescribing conformed in 32 of 173 (18%) of the patients compared with 451 of 546 (83%) during institution of ICF (P<0001; χ 2 test). Correspondingly, average overall omeprazole and ranitidine usage (inpatient and outpatient) and expenditure decreased (44% and 45%, respectively); collectively, use of less expensive alternatives increased about 61%. Estimated savings averaged about HK$150,000 ($20,000) per month. No comparable changes in usage were noted in 9 other local hospitals. Conclusion: Regarding hospital antiulcer drugs, this ICF strategy was associated with more rational prescribing and usage, and an important saving of resources.
Persistent Identifierhttp://hdl.handle.net/10722/84397
ISSN
2015 Impact Factor: 7.268
2015 SCImago Journal Rankings: 2.414
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKumana, CRen_HK
dc.contributor.authorChing, TYen_HK
dc.contributor.authorCheung, Een_HK
dc.contributor.authorKong, Yen_HK
dc.contributor.authorKou, Men_HK
dc.contributor.authorChan, CKen_HK
dc.contributor.authorChu, KMen_HK
dc.contributor.authorSeto, WHen_HK
dc.contributor.authorLam, SKen_HK
dc.date.accessioned2010-09-06T08:52:28Z-
dc.date.available2010-09-06T08:52:28Z-
dc.date.issued1998en_HK
dc.identifier.citationClinical Pharmacology And Therapeutics, 1998, v. 64 n. 5, p. 569-574en_HK
dc.identifier.issn0009-9236en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84397-
dc.description.abstractObjective: To determine whether immediate concurrent feedback (ICF) focused on inpatient omeprazole prescribing achieved more rational and cost- effective antiulcer drug prescribing and usage. Methods: In a 1400-bed teaching hospital, an audit (by specially trained personnel) was conducted to monitor inpatient prescribing of omeprazole (1) in preference to H 2- antagonists and other drugs according to agreed criteria (Helicobacter pylori eradication, severe reflux esophagitis, rapid ulcer healing deemed urgent because of severe symptoms or complications, high-dose steroid therapy of ≥30 mg/day prednisolone) and (2) appropriateness of intravenous dosing (oral route not feasible or contraindicated). After baseline monitoring for 1 month, followed by relevant antiulcer drug therapy education, ICF was instituted for 1 year. This entailed explanatory memoranda requesting a change in prescribing issued to the respective medical teams of patients whose omeprazole prescription did not 'conform.' The main outcomes of the study were omeprazole prescription numbers per month and the proportion conforming, defined daily doses of antiulcer drugs used and corresponding expenditures, and pertinent antiulcer drug utilization data from 9 other local hospitals. Results: Baseline omeprazole prescribing conformed in 32 of 173 (18%) of the patients compared with 451 of 546 (83%) during institution of ICF (P<0001; χ 2 test). Correspondingly, average overall omeprazole and ranitidine usage (inpatient and outpatient) and expenditure decreased (44% and 45%, respectively); collectively, use of less expensive alternatives increased about 61%. Estimated savings averaged about HK$150,000 ($20,000) per month. No comparable changes in usage were noted in 9 other local hospitals. Conclusion: Regarding hospital antiulcer drugs, this ICF strategy was associated with more rational prescribing and usage, and an important saving of resources.en_HK
dc.languageengen_HK
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/clpt/index.htmlen_HK
dc.relation.ispartofClinical Pharmacology and Therapeuticsen_HK
dc.rightsClinical Pharmacology and Therapeutics. Copyright © Mosby, Inc.en_HK
dc.titleAntiulcer drug prescribing in hospital successfully influenced by 'immediate concurrent feedback'en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0009-9236&volume=64&spage=569&epage=74&date=1998&atitle=Antiulcer+Drug+Prescribing+in+Hospital+successfully+influenced+by+%27Immediate+Concurrent+Feedback%27en_HK
dc.identifier.emailChu, KM: chukm@hkucc.hku.hken_HK
dc.identifier.authorityChu, KM=rp00435en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0009-9236(98)90141-2-
dc.identifier.pmid9834050-
dc.identifier.scopuseid_2-s2.0-0031772168en_HK
dc.identifier.hkuros39399en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0031772168&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume64en_HK
dc.identifier.issue5en_HK
dc.identifier.spage569en_HK
dc.identifier.epage574en_HK
dc.identifier.isiWOS:000077167800013-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridKumana, CR=7005112381en_HK
dc.identifier.scopusauthoridChing, TY=36956636300en_HK
dc.identifier.scopusauthoridCheung, E=19433915300en_HK
dc.identifier.scopusauthoridKong, Y=19434835900en_HK
dc.identifier.scopusauthoridKou, M=7004545950en_HK
dc.identifier.scopusauthoridChan, CK=55031167800en_HK
dc.identifier.scopusauthoridChu, KM=7402453538en_HK
dc.identifier.scopusauthoridSeto, WH=7005799377en_HK
dc.identifier.scopusauthoridLam, SK=7402279473en_HK

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