ED drug storage location influences prescribing
Adding drugs to an emergency department (ED) automated medication management system (ED AMMS) influences the frequency with which physicians prescribe them, according to a study from the University of Rochester reported in the May 2006 Academic Emergency Medicine Journal. Gregory P. Conners, MD, vice chair for academic affairs at the University of Rochester Medical Center, and Daniel P. Hays, a clinical pharmacist specialist at the medical center, said many hospital EDs have access to an extensive central hospital pharmacy-based drug formulary, and to a limited drug set through an ED-based automated medication management system.
Since emergency physicians may preferentially order drugs available from an ED AMMS, they hypothesized that 1) adding drugs to the ED AMMS would alter the frequency with which they were ordered; and 2) actually filling orders after the ED AMMS inclusion date from the ED AMMS vs. the central hospital pharmacy would influence the magnitude of the effect.
To test their hypotheses, Conners and Hays identified all drugs/formulations available in at least one of several Pyxis ED AMMS units in the University of Rochester ED that were added to the ED AMMS in the previous three years, not directly affected by hospital formulary/practice changes, and previously available from the hospital central pharmacy. Using an existing pharmacy database, they retrospectively compared drug order frequencies after vs. before the drugs' ED AMMS inclusion and the location from which each post-ED AMMS drug order was filled.
Four drugs/formulations met the study criteria — moxifloxicin injection, moxifloxicin tablets, azithromycin injection, and pantoprazole injection. The study results indicated that all four were significantly more commonly ordered after ED AMMS inclusion. And the magnitude of order increases strongly correlated with order filling (after the date of ED AMMS inclusion) from the ED AMMS rather than from the central hospital pharmacy.
Conners and Hays concluded that drugs/formulations are more frequently ordered in an ED after they are included in an ED AMMS and that the more readily drugs are dispensed from an ED AMMS rather than the central hospital pharmacy, the larger the increase.
Adding drugs to an emergency department (ED) automated medication management system (ED AMMS) influences the frequency with which physicians prescribe them, according to a study from the University of Rochester reported in the May 2006 Academic Emergency Medicine Journal.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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