A simple institutional educational intervention to decrease use of selected expensive medications.
OBJECTIVE
To determine whether a simple educational intervention can influence use of prescription medications at an institution.


METHODS
Cost-effectiveness analysis of prescribing behavior before and after an educational intervention.


METHODS
A large, urban, free-standing academic rehabilitation hospital.


METHODS
Physicians, residents, and physician extenders.


METHODS
The hospital's pharmacy department provided simple written educational material about cost differences of various prescription medications to attending and resident physicians, nurse leaders, and case managers. Telephoned reminders were given when targeted medications were prescribed.


METHODS
Total prescription medication use was recorded monthly for 12 months before and after the intervention. Pharmaceuticals monitored were subcutaneously administered anticoagulants, histamine type 2 (H2) blockers, and nonsteroidal anti-inflammatory drugs (NSAIDs).


RESULTS
A 32% decrease in use of the more costly anticoagulant and a 20% increase in use of the less costly anticoagulant (p <.0001), representing an estimated annual savings of nearly $66,000. Use of more costly H2 antagonist decreased 50% and use of less costly H2 antagonist increased 128% (p <.0001). With written intervention only, use of more costly NSAIDs declined 28%, whereas use of less costly NSAIDs increased 58% (p <.0020).


CONCLUSIONS
Providing physicians with simple pharmaceutical cost information and telephone reminders decreased the use of targeted more costly medications.
Roth
E J
EJ
Department of Physical Medicine and Rehabilitation, Northwestern University Medical School , the Rehabilitation Institute of Chicago, Chicago, IL, USA. Ejr@nwu.edu
Plastaras
C T
CT
Mullin
M S
MS
Fillmore
J
J
Moses
M L
ML
D000925:Anticoagulants / Q000191:economics; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics* / Q000592:standards; D004501:Education, Medical / Q000592:standards*; D017984:Enoxaparin / Q000191:economics; D015738:Famotidine / Q000191:economics; D007722:Health Knowledge, Attitudes, Practice; D006635:Histamine H2 Antagonists / Q000191:economics; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000191:economics
D000925:Anticoagulants; D017984:Enoxaparin; D006635:Histamine H2 Antagonists; D015738:Famotidine