Clinical Pharmacist-Led Impact on Inappropriate Albumin Use and Costs in the Critically Ill
| Autor: | Rajeev C. Saggar, Mitchell S. Buckley, Sumit K. Agarwal, Jake M. Lansburg, Brian L. Erstad, Laura M. Wicks, Emily C. Richards, Brian J. Kopp, Kristen D. Knutson |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Critical Care health care facilities manpower and services Critical Illness Inappropriate Prescribing 030204 cardiovascular system & hematology Pharmacists law.invention 03 medical and health sciences 0302 clinical medicine law Cost Savings Albumins medicine Humans Pharmacology (medical) 030212 general & internal medicine Hospital Mortality Intensive care medicine Retrospective Studies Academic Medical Centers Critically ill business.industry Middle Aged Intensive care unit Drug Utilization Clinical pharmacy Intensive Care Units Female business |
| Zdroj: | The Annals of pharmacotherapy. 54(2) |
| ISSN: | 1542-6270 |
| Popis: | Background:Optimal albumin use in the intensive care unit (ICU) remains challenging with inappropriate use approaching 50%. No published reports have described clinical pharmacist impact aimed at mitigating inappropriate albumin use in the ICU. Objective: To evaluate the clinical and economic impact of a clinical pharmacist–led intervention strategy targeting inappropriate albumin in the ICU. Methods: A retrospective cohort study evaluated all adult (≥18 years) ICU patients administered albumin at an academic medical center over a 2-year period. Institutional guidelines were developed with clinical pharmacists targeting inappropriate albumin use. The primary end point was to compare inappropriate use of albumin administered before and after pharmacist intervention implementation. Secondary analyses compared the overall albumin use between study periods. In-hospital mortality, length of stay, and albumin-related costs between study periods were also compared. Results: A total of 4419 patients were identified, with 2448 (55.4%) critically ill patients included. The pharmacist-led strategy resulted in a 50.9% reduction of inappropriate albumin use ( P < 0.001). The rate of inappropriate albumin use was 44.3 ± 10.5 and 5.5 ± 2.9 g per patient-day in the preimplementation and postimplementation periods, respectively ( P < 0.001). Costs associated with overall and inappropriate albumin use in the ICU decreased by 34.8% and 87.1%, respectively. Total annual cost-savings was $355 393 in the ICUs. No differences in clinical outcomes were found. Conclusion and Relevance: Clinical pharmacist–led interventions reduced overall and inappropriate albumin use and costs without negatively affecting clinical outcomes. |
| Databáze: | OpenAIRE |
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