Long-Term Impacts of a Targeted Intervention in the Emergency Department on Inpatient Prescribing Practices.

J Pharm Pract

Department of Pharmaceutical Care, University of Iowa Hospitals and Clinics, Iowa City, IA, USA; Department of Emergency Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.

Published: February 2024

AI Article Synopsis

  • In 2009, researchers introduced an intervention aiming to reduce the use of multivitamin infusions (MVIs) for patients with alcohol-related issues in the emergency department (ED).
  • A retrospective study was conducted in a large hospital to assess how this intervention affected MVI prescribing practices between 2009 and 2019, focusing on both the ED and inpatient settings.
  • The findings revealed a significant decline in MVI orders, with a 3.5% reduction in inpatient settings and a 1.4% reduction in the ED, suggesting that the intervention had a lasting impact over the decade.

Article Abstract

In 2009, researchers successfully implemented an intervention to decrease the inappropriate prescribing of multivitamin infusions (MVIs) in the emergency department (ED) for patients presenting with alcohol-related illnesses. The purposes of our study were to determine the impact of the 2009 intervention on hospital-wide prescribing practices of vitamin therapies for alcohol-related illnesses, and to evaluate its long-term sustainability. A retrospective observational cohort study was conducted at a 60,000-visit ED, 811-bed academically-affiliated tertiary referral hospital with an average census of 515 and 714 patients in 2009 and 2019, respectively. Patients were included if they presented to the ED from 2009 to 2019 with an alcohol-related illness as defined by ICD-9 and ICD-10 codes. The primary outcome was the change in the monthly average of MVIs ordered inpatient within the first four months compared to the last four months of the study period. Secondary outcomes included changes in the mean distribution (MD) per month of thiamine administrations in the ED and inpatient setting, and MVIs ordered in the ED. The MD of MVIs ordered per month decreased by 3.5% (95% CI -5.3, -1.7) in the inpatient setting and decreased by 1.4% (95% CI -2.5, -.3) in the ED from the beginning to the end of our study period. This study suggests the effects of an intervention made in the ED sustained impact over a 10-year timeframe, and decreased the use of MVIs in both the ED and hospital-wide.

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http://dx.doi.org/10.1177/08971900221125077DOI Listing

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Long-Term Impacts of a Targeted Intervention in the Emergency Department on Inpatient Prescribing Practices.

J Pharm Pract

February 2024

Department of Pharmaceutical Care, University of Iowa Hospitals and Clinics, Iowa City, IA, USA; Department of Emergency Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.

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  • In 2009, researchers introduced an intervention aiming to reduce the use of multivitamin infusions (MVIs) for patients with alcohol-related issues in the emergency department (ED).
  • A retrospective study was conducted in a large hospital to assess how this intervention affected MVI prescribing practices between 2009 and 2019, focusing on both the ED and inpatient settings.
  • The findings revealed a significant decline in MVI orders, with a 3.5% reduction in inpatient settings and a 1.4% reduction in the ED, suggesting that the intervention had a lasting impact over the decade.
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