title: Thiamine prescribing practices within university-affiliated hospitals: a multicenter retrospective review.
abstract: BACKGROUND
  Patients with suspected thiamine deficiency should receive treatment with parenteral thiamine to achieve the high serum thiamine levels necessary to reverse the effects of deficiency and to circumvent problems with absorption common in the medically ill.
  
  
  OBJECTIVE
  To quantify rates of parenteral administration of thiamine across university-affiliated hospitals and to identify factors associated with higher rates of parenteral prescribing.
  
  
  METHODS
  Multicenter, retrospective observational study of thiamine prescriptions.
  
  
  METHODS
  Prescriptions for thiamine were captured from computerized pharmacy information systems across participating centers, providing information concerning dose, route, frequency, and duration of thiamine prescribed from January 2010 to December 2011.
  
  
  METHODS
  Fourteen university-affiliated tertiary care hospitals geographically distributed across Canada, including 48,806 prescriptions for thiamine provided to 32,213 hospitalized patients.
  
  
  RESULTS
  Parenteral thiamine accounted for a statistically significant majority of thiamine prescriptions (57.6%, P < 0.001); however, oral thiamine constituted a significant majority of the total doses prescribed (68.4%, z = 168.9; P < 0.001). Protocols prioritizing parenteral administration were associated with higher rates of parenteral prescribing (61.3% with protocol, 45.8% without protocol; P < 0.001). Patients admitted under psychiatry services were significantly more likely to be prescribed oral thiamine (P < 0.001).
  
  
  CONCLUSIONS
  Although parenteral thiamine accounted for a statistically significant majority of prescriptions, oral thiamine was commonly prescribed within academic hospitals. Additional strategies are needed to promote parenteral thiamine prescribing to patients with suspected thiamine deficiency.
authors: Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada.
authors: Gregory S
authors: GS
authors: Day
authors: Safiya
authors: S
authors: Ladak
authors: Kevin
authors: K
authors: Curley
authors: Norman A S
authors: NA
authors: Farb
authors: Paul
authors: P
authors: Masiowski
authors: Tamara
authors: T
authors: Pringsheim
authors: Michael
authors: M
authors: Ritchie
authors: Alexandra
authors: A
authors: Cheung
authors: Sandy
authors: S
authors: Jansen
authors: Linda
authors: L
authors: Methot
authors: Heather L
authors: HL
authors: Neville
authors: Duane
authors: D
authors: Bates
authors: Donna
authors: D
authors: Lowe
authors: Natasha
authors: N
authors: Fernandes
authors: Alexandre
authors: A
authors: Ferland
authors: C
authors: C
authors: Martin del Campo
mesh_terms: D011307:Drug Prescriptions; D006785:Hospitals, University / Q000639:trends*; D006801:Humans; D012189:Retrospective Studies; D013831:Thiamine / Q000008:administration & dosage*; D013832:Thiamine Deficiency / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D013831:Thiamine