Drug-use review program for concurrent histamine H2-receptor antagonist-sucralfate therapy

Area of Science:

• Pharmacoeconomics
• Health Services Research
• Gastroenterology

Background:

• Concomitant use of histamine H2-receptor antagonists and sucralfate is common.
• Appropriate use criteria for this combination therapy were lacking.
• Potential for inappropriate prescribing and associated costs.

Purpose of the Study:

• To evaluate the effect of drug-use review on histamine H2-receptor antagonist-sucralfate therapy.
• To assess the impact of implementing criteria-based guidelines on prescribing patterns.
• To determine cost savings resulting from the intervention.

Main Methods:

• A drug-use review intervention was implemented at a Veterans Affairs medical center.
• Criteria for appropriate use of histamine H2-receptor antagonist-sucralfate combination therapy were developed and introduced.
• Prescribing patterns were assessed before and after the intervention.

Main Results:

• The number of treatment courses decreased by 30% after the intervention.
• Only one of 109 postintervention courses met the established criteria for indication and duration.
• Annual cost savings of $25,000 were achieved.

Conclusions:

• Drug-use review and criteria-based guidelines are effective in reducing inappropriate combination therapy.
• The intervention successfully curtailed the use of histamine H2-receptor antagonist-sucralfate therapy.
• Significant cost savings can be realized through optimized prescribing practices.