title: Outcomes of a decision support prompt in community pharmacy-dispensing software to promote step-down of proton pump inhibitor therapy.
abstract: OBJECTIVE
  To evaluate the effect of a computerized decision support prompt regarding high-dose proton pump inhibitor (PPI) therapy on prescribing and medication costs.
  
  
  METHODS
  A prompt activated on dispensing high-dose esomeprazole or pantoprazole was implemented in 73 of 185 pharmacies. Anonymized prescription data and a patient survey were used to determine changes in prescribing and associated medication costs.
  
  
  RESULTS
  The pharmacist-recorded PPI intervention rate per 100 high-dose PPI prescriptions was 1.67 for the PPI prompt group and 0.17 for the control group (P < 0.001). During the first 28 days of the trial, 196 interventions resulted in 34 instances of PPI step-down, with 28 of these occurring in PPI prompt pharmacies. Cost savings attributable to the prompt were AUD 7.98 (£4.95) per month per PPI prompt pharmacy compared with AUD 1.05 (£0.65) per control pharmacy.
  
  
  CONCLUSIONS
  The use of electronic decision support prompts in community pharmacy practice can promote the quality use of medicines.
authors.affiliation: Unit for Medication Outcomes Research and Education, School of Pharmacy, University of Tasmania, Hobart, Tasmania, Australia. colin.curtain@utas.edu.au
authors.forename: Colin
authors.initials: C
authors.lastname: Curtain
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Peterson
authors.forename: Peter
authors.initials: P
authors.lastname: Tenni
authors.forename: Ivan K
authors.initials: IK
authors.lastname: Bindoff
authors.forename: Mackenzie
authors.initials: M
authors.lastname: Williams
mesh_terms: D001315:Australia; D003157:Community Pharmacy Services / Q000191:economics; D003661:Decision Support Techniques; D016527:Drug Costs / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D004360:Drug Therapy, Computer-Assisted / Q000191:economics / Q000379:methods*; D006801:Humans; D017063:Outcome Assessment, Health Care; D054328:Proton Pump Inhibitors / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D012984:Software
chemical_list: D054328:Proton Pump Inhibitors