Emergency department drug orders: does drug storage location make a difference?

Area of Science:

• Pharmacy
• Health Informatics
• Clinical Practice

Background:

• Emergency departments (EDs) rely on efficient medication management systems.
• Availability of medications from central pharmacies can impact ordering patterns.
• Automated medication management systems aim to streamline drug accessibility and ordering.

Purpose of the Study:

• To investigate the impact of integrating previously central-pharmacy-only drugs into an ED automated medication management system.
• To quantify changes in drug ordering frequency following system integration.

Main Methods:

• Retrospective analysis of a pharmacy database from a large, urban, academic teaching hospital.
• Calculation of drug-ordering frequencies before and after study drugs were added to the ED automated medication management system.
• Inclusion of drugs recently added to the ED system, still available from the central pharmacy, without changes in prescribing protocols.

Main Results:

• Four drug preparations (moxifloxacin injection/tablets, azithromycin injection, pantoprazole injection) showed substantial increases in ordering frequency (4.0- to 25.0-fold).
• Ordering frequency increases strongly correlated with the proportion of orders filled via the ED system versus the central pharmacy.
• The ED automated medication management system integration led to significant shifts in drug ordering patterns.

Conclusions:

• Integrating drug preparations into an ED automated medication management system demonstrably increases their ordering frequency.
• Reliable access through the ED system, compared to the central hospital pharmacy, is a key factor in increased ordering.
• Automated medication management systems actively influence physician prescribing behavior in the ED setting.