Adjusting dosage intervals of intermittent intravenous ranitidine according to creatinine clearance: a cost-minimization analysis.
To provide effective ranitidine therapy at the lowest possible cost to institutions and patients, the main study objectives were to develop a dosage intervention strategy for intermittent intravenous ranitidine and to document the resultant cost savings through cost-minimization analysis. During a 6-week baseline phase, a pharmacy resident prospectively monitored all patients in the intensive care unit receiving intravenous ranitidine and evaluated appropriateness of dose according to creatinine clearance. Staff pharmacists collected identical data during the 6-week intervention phase but also made recommendations for dosage interval adjustment. In patients with creatinine clearance rates less than 50 mL per minute, the mean number of doses per patient treatment-day was reduced from 2.33 +/- 0.81 during baseline phase to 1.56 +/- 0.70 during intervention phase (P < 0.001). The hospital cost per patient treatment-day was decreased by 33%, from $5.29 +/- 1.83 to $3.54 +/- 1.59 (P < 0.001). Thus a program of prospective monitoring and verbal interventions by pharmacists effectively reduced the number of inappropriate ranitidine doses and hospital cost.
North Carolina Baptist Hospitals, Winston-Salem 27157.
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Connelly
D000328:Adult; D000368:Aged; D017046:Cost Savings; D003404:Creatinine / Q000652:urine*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016903:Drug Monitoring / Q000191:economics*; D006746:Hospital Bed Capacity, 500 and over; D017721:Hospital Costs; D016519:Hospitals, Religious; D006801:Humans; D007275:Injections, Intravenous; D008875:Middle Aged; D009657:North Carolina; D010607:Pharmacy Service, Hospital / Q000191:economics*; D011899:Ranitidine / Q000008:administration & dosage* / Q000191:economics*