Effect of educational and policy interventions on institutional utilization of wet nebulization respiratory drugs and portable inhalers.
| Autor: | Lowe DO; Department of Pharmacy Services, University Health Network, Toronto, Ontario. donna.lowe@uhn.on.ca, Lummis H, Zhang Y, Sketris IS |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | The Canadian journal of clinical pharmacology = Journal canadien de pharmacologie clinique [Can J Clin Pharmacol] 2008 Summer; Vol. 15 (2), pp. e334-43. Date of Electronic Publication: 2008 Sep 05. |
| Abstrakt: | Background: Asthma and chronic obstructive pulmonary disease treatment guidelines support the preferential use of portable inhalers (PIs) over wet nebulization (WN) respiratory therapy. Hospital- and community-based educational initiatives and a community-based provincial drug program policy change were previously implemented to promote the conversion of WN therapy to PI and spacer device use in Nova Scotia. Objective: To examine the effect of these interventions on salbutamol, ipratropium bromide, and spacer device (Aerochamber) use at the Queen Elizabeth II Health Sciences Centre (QEII HSC). Methods: We conducted a time-series analysis of drug utilization data from August 1998 to July 2005. We used two intervention phases compared to the pre-intervention phase to determine whether the educational and policy interventions were associated with significant changes in monthly drug and spacer device utilization rates at the QEII HSC (1000-bed teaching hospital; Halifax, Nova Scotia). Results: Salbutamol and ipratropium bromide PI use significantly increased in both intervention phases, compared to the pre-intervention phase. Mean (SD) defined daily doses/100 bed-days for salbutamol PI increased from 30.4 (0.4) in the pre-intervention phase to 34.6 (0.9) and 37.0 (0.4) in intervention phases I and II respectively (p<0.001 for both), and ipratropium bromide PI increased from 27.3 (3.5) to 32.8 (2.5) in intervention phase I (p=0.004) and 35.6 (3.5) in intervention phase II (p<0.001). However, a significant corresponding decrease was observed with salbutamol WN only. Mean (SD) Aerochamber units/100 bed-days significantly increased. Conclusions: Educational and policy interventions had limited effects on converting WN to PI use at the QEII HSC. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|