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Influencing prescribing behavior by adapting computerized order-entry pathways.

N E Kawahara1, F M Jordan

  • 1University of Illinois, Department of Pharmacy Practice, College of Pharmacy 60612.

American Journal of Hospital Pharmacy
|September 1, 1989
PubMed
Summary
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Computerized drug order entry systems can guide prescribing. Informational text interventions significantly reduced the use of cefuroxime and increased cefonicid use, lowering antibiotic costs for pneumonia patients.

Area of Science:

  • Health Informatics
  • Pharmacoeconomics
  • Clinical Pharmacy

Background:

  • Hospital pharmacies face challenges in controlling drug costs and optimizing prescribing patterns.
  • Traditional methods for influencing physician prescribing behavior have limitations.

Purpose of the Study:

  • To evaluate the impact of informational text integrated into a computerized drug order-entry system on prescribing patterns and costs.
  • To assess the effectiveness of altering drug selection within an electronic health record interface.

Main Methods:

  • An intervention was implemented in a teaching hospital's computerized drug order-entry system.
  • Informational text recommending cefonicid over cefuroxime for pneumonia was added to the order screen.
  • System modifications allowed easier selection of alternative antibiotics.

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Main Results:

  • Prescribing of cefuroxime for specific pneumonia patients decreased from 100% to 22% between January 1986 and December 1987.
  • Prescribing of cefonicid increased from 0% to 78% during the same period.
  • Average antibiotic acquisition cost per patient decreased from $123 to $48.

Conclusions:

  • Computerized order-entry pathways can be effectively adapted to influence physician prescribing behavior.
  • This intervention demonstrates a successful strategy for cost containment in pharmaceutical management.
  • Further attention to such health informatics interventions is warranted.