An Evaluation of a Pharmacist-Managed Intravenous to Oral Medication Conversion Program
Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
Introduction: Unnecessary continuation of intravenous (IV) medication administration results in increased costs to patients and the institution as well as prolonged length of hospital stay and risk for infection and related complications. UCSF Medical Center implemented an IV to oral (PO) medication conversion program in March 2013, where pharmacists under protocol convert eligible patients on one or more of 15 select medications.
Aim: In order to assure quality; Assess the number of IV to PO conversions made during the first six months of protocol implementation and identify the most common reasons for physician rejection, also to characterize cost implications after the implementation.
Materials and Methods: In this retrospective single-group analysis, data was collected from a feature in the medical record system containing pharmacist notes specific for IV to PO conversions. Inpatient medication acquisition prices for UCSF were obtained and cost for pharmacist labor and fixed costs associated with protocol implementation were estimated.
Results: 800 conversions were accepted and 18 were rejected with patient meeting protocol exclusion criteria as the most common reason. Acquisition cost savings of US$ 11 564 were realized for the six-month period with the assumption of one day of IV therapy saved.
Conclusions: This study is unique in that it evaluates a comprehensive IV to PO medication conversion program with 15 different medications from different pharmacological classes. Savings have been realized, however, saving of one day of IV therapy is a relatively moderate assumption considering findings in previous studies, likely resulting in an underestimation of the savings. No adverse events were reported during the 6-month study period and relatively few conversions were rejected by the provider, which can be interpreted as that the implementation of the pharmacist-managed program has been safe and useful.
Place, publisher, year, edition, pages
2014. , 29 p.
Social and Clinical Pharmacy
IdentifiersURN: urn:nbn:se:uu:diva-221515OAI: oai:DiVA.org:uu-221515DiVA: diva2:709725
University of California San Francisco
Subject / course
Master of Science Programme in Pharmacy
Tsourounis, Candy, Professor
Hammarlund-Udenaes, Margareta, Professor