Laboratory tests recommended by pharmacists in a skilled-nursing facility.

The types of laboratory tests recommended by pharmacists in a 185-bed skilled-nursing facility, the rate of physician acceptance of the recommendations, the reasons for and costs of the tests, and the outcomes of the tests were determined. Patients for whom laboratory tests had been recommended by a pharmacist from 1982 to 1987 were identified; this information had been taken from patients' charts during routine review by a pharmacist and entered into a computer database. The following information was recorded: type of laboratory test recommended, physician response to the recommendation, cost of the test, and outcome of the test. The investigator determined reasons for the recommendations by using the Department of Health and Human Services list of apparent irregularities that, if present, could indicate problems with drug therapy. During the study period, pharmacists requested 99 tests for 63 patients; physicians ordered 87 (87.9%) of those tests. Tests done most frequently were the SMA-6 (serum concentrations of sodium, potassium, chloride, glucose, blood urea nitrogen, and carbon dioxide), serum concentrations of various drugs, and anticoagulation studies. The reasons given most frequently for requesting the tests were routine monitoring, the most recent results being more than six months old, suspected drug toxicity or drug-drug interactions, and the need for information to determine whether drug therapy should continue. Results of 36 of the tests prompted a change in drug therapy, whereas 56 tests indicated that the current therapy was appropriate and safe.(ABSTRACT TRUNCATED AT 250 WORDS)