Improving antiulcer agent prescribing in a health maintenance organization

D. W. Raisch, J. L. Bootman, L. N. Larson, W. F. McGhan

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

A study was made of the effect of one-to-one educational meetings between prescribers and a pharmacist on the prescribing of antiulcer agents for outpatients in a health maintenance organization (HMO). Ten-minute presentations were developed that communicated the same basic facts through the use of case studies (vivid interventions) or statistical data (nonvivid interventions). After a control group (n = 8) was selected, prescribers (n = 16) were randomly assigned to receive vivid interventions or nonvivid interventions. Data n the presecribing of cimetidine, ranitidine, and sucralfate were collected for one month before the interventions and for two months afterward. Three clinical pharmacy professors independently evaluated prescriptions for appropriateness of indication, dosage, and duration. No differences in appropriateness were found between the two intervention groups, but in the first postintervention month the mean rate of inappropriate prescribing per control practitioner was 80%, versus < 32% for the intervention groups (p < 0.01). Each prescription in the first postintervention month entailed a mean cost of $31 per control practitioner for inappropriate prescribing, compared with < $12 for the intervention groups (p <0.01). Mean costs of inappropriate prescriptions per practitioner per patient visit were $0.88 and ≤ $0.41 for the control and intervention groups, respectively (p < 0.05). During postvisit month 2, inappropriate prescribing for both intervention groups increased slightly and was no longer significantly less than that in the control group. One-to-one educational meetings improved the prescribing of antiulcer agents for outpatients in an HMO.

Original languageEnglish (US)
Pages (from-to)1766-1773
Number of pages8
JournalAmerican Journal of Hospital Pharmacy
Volume47
Issue number8
StatePublished - Jan 1 1990
Externally publishedYes

Keywords

  • Cimetidine
  • Costs
  • Dosage
  • Dosage schedules
  • Education
  • Gastrointestinal drugs
  • Health maintenance organizations
  • Pharmacists, institutional
  • Ranitidine
  • Rational therapy
  • Surface

ASJC Scopus subject areas

  • Leadership and Management
  • Pharmaceutical Science

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