title: Real world efficacy of alvimopan on elective bowel resection patients: an analysis of statistical versus clinical significance.
abstract: BACKGROUND
  Alvimopan has been shown to shorten time to return of bowel function (RBF), thereby decreasing length of stay (LOS). The aim of this study was to assess the clinical significance of this effect on actual practice. METJODS: A retrospective and prospective study of elective bowel resection patients was performed. Surgeons were assigned to alvimopan users (treatment) or nonusers (control). Primary outcome measures included LOS, RBF, and total hospital cost (THC).
  
  
  RESULTS
  Mean RBF was 2.93 ± 1.22 days in the treatment group and 4.22 ± 1.81 days in the control group (P < .001). Mean LOS was 7 ± 2.6 days in the treatment group and 7.2 ± 2.2 days in the control group. Mean THC was $7,584 ± $4,770 in the treatment group and $7,310 ± $5,471 in the control group (P > .81). LOS decreased by 2.5 days compared with the historical controls, independent of alvimopan use.
  
  
  CONCLUSIONS
  Alvimopan improved RBF but not LOS or THC. Reductions in average LOS of 1 day for ≤6 doses and 2 days if patients received >6 doses were needed to decrease THC.
authors.affiliation: Pharmacy Practice Residency, Conemaugh Memorial Hospital, Johnstown, PA, USA.
authors.forename: Sara L
authors.initials: SL
authors.lastname: Gaines
authors.forename: Kathryn
authors.initials: K
authors.lastname: Giroux
authors.forename: Stephanie
authors.initials: S
authors.lastname: Thomas
authors.forename: James S
authors.initials: JS
authors.lastname: Gregory
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D013505:Digestive System Surgical Procedures / Q000191:economics; D016527:Drug Costs / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000191:economics; D005260:Female; D005765:Gastrointestinal Agents / Q000191:economics / Q000627:therapeutic use*; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D045823:Ileus / Q000209:etiology / Q000517:prevention & control*; D007422:Intestines / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000191:economics / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D020127:Recovery of Function; D012189:Retrospective Studies; D014481:United States
chemical_list: D005765:Gastrointestinal Agents; D010880:Piperidines; C419502:alvimopan