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JAMES C. GARRELTS, B.S., PHARM.D., FASHP, is Director of Pharmacy, Via Christi Regional Medical Center, Wichita, KS; at the time of this study he was Manager, Clinical Pharmacy Services, Wesley Medical Center (WMC), Wichita. AMBERMEISTER, PHARM.D., is Adult Critical Care Clinical Specialist; and JACK BOND, B.S., M.H.S., is Director of Pharmacy, WMC.

Address correspondence to Dr. Garrelts at Clinical Pharmacy Services,Via Christi Regional Medical Center, St. Francis Campus, 929 North St. Francis, Wichita, KS 67214 (jim_garrelts{at}via-christi.org).

Purpose. The effect of a required preprinted order form on the prescribing of epoetin alfa was evaluated. Summary. An initial drug-use evaluation (DUE) was conducted in January 2004 to determine how closely prescribing guidelines for epoetin alfa were being followed. A preprinted order form was then developed and approved by the medical staff, with use required for all adult epoetin alfa orders. A follow-up DUE was conducted in January 2006 to assess the effects of the preprinted order form on prescribing patterns. Expenditures for epoetin alfa for 12 months before and after implementation of the preprinted order form were also calculated. Data for 45 and 44 patients were reviewed for the initial and follow-up DUEs, respectively. Smaller doses were ordered at more frequent intervals and epoetin alfa was prescribed more often by nephrologists and less frequently by surgeons and critical care intensivists after implementation of the preprinted order form. Use of epoetin alfa according to hospital guidelines improved from 44% to 73% (p = 0.0089). Significantly more patients’ ferritin and transferrin saturation values were measured postimplementation of the order form (p = 0.0176). In addition, the annual expense for epoetin alfa was reduced by $151,042, a 36% reduction from baseline. Conclusion. Implementation of a required preprinted order form increased the frequency of appropriate prescribing of epoetin alfa in a community teaching hospital. Index terms: Costs; Dosage; Drug use; Epoetin alfa; Forms; Hematopoietic agents; Medication orders; Physicians; Prescribing; Protocols; Rational therapy

 

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