Optimizing Prescribing Practices of High-Cost Medications With Computerized Alerts in the Inpatient Setting.
Current literature does not consistently show a benefit to providing medication cost information to inpatient health care prescribers. This study assessed the effectiveness of computerized provider order entry alerts that displayed the cost of a high-cost medication alongside a lower cost alternative, targeting 3 high-cost medications. Medication utilization during the one year prior to the intervention was compared to usage in the year after implementation. Reduced utilization of high-cost medications was found when comparing pre to post. Ipratropium hydrofluoroalkane and fluticasone hydrofluoroalkane metered dose inhaler utilization were reduced by 29% and 62%, respectively ( P < .001 for both). A 71% decrease in intravenous chlorothiazide was observed ( P < .001); however, its effect was unable to be separated from implementation of a heart failure diuretic protocol during the study period. Overall, these results suggest computerized medication cost alerts that recommend a lower cost therapeutic alternative are effective in changing prescribing practices.
1 UW Medicine, Seattle, WA.
Gregory
G
Gipson
1 UW Medicine, Seattle, WA.
Janet L
JL
Kelly
1 UW Medicine, Seattle, WA.
Christy M
CM
McKinney
1 UW Medicine, Seattle, WA.
Andrew A
AA
White
D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D016527:Drug Costs / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients; D050316:Medical Order Entry Systems / Q000458:organization & administration*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
computerized alerts; decision support; medication cost; prescription drugs