Clinical guidelines and pharmacist intervention program for HIV-infected patients requiring granulocyte colony-stimulating factor therapy.
Guidelines, implemented by clinical pharmacists, were developed by the pharmacy and therapeutics subcommittee on a dedicated service caring for hospitalized patients with human immunodeficiency virus infection or the acquired immunodeficiency syndrome (AIDS) who required granulocyte colony-stimulating factor (G-CSF) therapy. Drug use and evaluation was conducted on all patients with AIDS who were prescribed G-CSF, and education was provided to medical house staff. Clinical data from chart review and laboratory and billing data bases of the hospital medical information system were compared for the 9-month intervention period (IP) with data from the 9-month preintervention period (PIP). Comparing the IP and PIP, the mean number of G-CSF doses (0.29 vs 0.51) and pharmacy costs per day ($112 vs $200) decreased, with no change in the number of patients requiring G-CSF. The 1.3 pharmacist interventions per patient resulted in a decrease to 2.4 doses per admission from a baseline of 5.9 (p<0.0001). Mean hospital stay (11.9 vs 13.8 days) and mean number of days of neutropenia did not differ for IP and PIP groups. Effectively implemented pharmacist-based interventions can decrease hospital costs without increasing patient morbidity.
Engles-Horton
L L
LL
Department of Pharmacy, Yale-New Haven Hospital, Connecticut, USA.
Skowronski
C
C
Mostashari
F
F
Altice
F L
FL
D000328:Adult; D003237:Connecticut; D003365:Costs and Cost Analysis; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000191:economics; D015658:HIV Infections / Q000188:drug therapy*; D017048:Health Care Costs; D006746:Hospital Bed Capacity, 500 and over; D006785:Hospitals, University / Q000191:economics / Q000592:standards; D006801:Humans; D008297:Male; D010607:Pharmacy Service, Hospital / Q000191:economics / Q000592:standards*; D010606:Pharmacy and Therapeutics Committee / Q000592:standards; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
D016179:Granulocyte Colony-Stimulating Factor