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Related Experiment Videos

Routine laboratory tests: helpful or just costly?

J W Cooper

    Nursing Homes and Senior Citizen Care
    |November 5, 1988
    PubMed
    Summary
    This summary is machine-generated.

    Consultant pharmacists identified underuse of key lab tests like drug levels and serum creatinine in nursing homes. Optimizing lab test utilization improved drug therapy and avoided significant unnecessary healthcare costs.

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    Area of Science:

    • Geriatric Pharmacy
    • Clinical Laboratory Science
    • Pharmacoeconomics

    Background:

    • Appropriate utilization of laboratory tests is crucial for effective patient care, particularly in geriatric settings.
    • Underuse of specific tests (e.g., drug levels, renal function) can lead to suboptimal therapeutic outcomes.
    • Overuse of routine laboratory monitoring can result in significant, unnecessary healthcare expenditures.

    Purpose of the Study:

    • To evaluate the utilization of laboratory tests in a geriatric nursing home setting.
    • To assess the impact of consultant pharmacist recommendations on laboratory test ordering and drug therapy.
    • To determine the cost-effectiveness of appropriate laboratory test utilization versus routine, excessive monitoring.

    Main Methods:

    • A consultant pharmacist conducted a two-year study in a 72-bed geriatric nursing home.

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  • Evaluated underutilization of drug levels (digoxin, phenytoin, theophylline), serum electrolytes, and serum creatinine.
  • Tracked prescriber acceptance of recommendations and subsequent changes in drug therapy and associated costs.

    • Main Results:

    • 95% prescriber acceptance of pharmacist recommendations for lab monitoring led to drug therapy changes in 87.5% of cases.
    • 32 of 35 authorized lab tests resulted in significant changes to drug therapy (dose, schedule, or additional therapy).
    • Optimized lab ordering cost $2,560, while excessive routine monitoring incurred $71,566 in unnecessary costs over two years.

    Conclusions:

    • Targeted laboratory test utilization, guided by clinical pharmacist expertise, significantly improves drug therapy management in geriatric nursing homes.
    • Implementing appropriate lab monitoring protocols can lead to substantial cost savings by avoiding unnecessary testing.
    • The study highlights the value of pharmacist-led interventions in optimizing diagnostic testing and healthcare resource allocation.