Impact of an Intravenous Fluconazole Restriction Policy on Patient Outcomes
OBJECTIVE: To evaluate both the economic and clinical impact of an intravenous fluconazole restriction policy in a university teaching hospital. METHODS: Intravenous fluconazole was restricted to patients unable to take oral medications due to significant nausea or to patients whose oral intake was...
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| Veröffentlicht in: | The Annals of pharmacotherapy 2001-01, Vol.35 (1), p.9-13 |
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| creator | Burkiewicz, Jill S Kostiuk, Karen A Jacobs, Richard A Guglielmo, B Joseph |
| description | OBJECTIVE:
To evaluate both the economic and clinical impact of an intravenous fluconazole restriction policy in a university teaching hospital.
METHODS:
Intravenous fluconazole was restricted to patients unable to take oral medications due to significant nausea or to patients whose oral intake was restricted. A retrospective chart review and computerized record review was conducted in patients receiving intravenous or oral fluconazole from January 1 to June 30, 1997, and again from January 1 to June 30, 1998, after implementation of the policy.
RESULTS:
Six-month institutional expenditures for intravenous fluconazole decreased following policy implementation, from $81 900 to $45 400, an estimated annual institutional savings of $73 000. A 47% reduction in the number of patients treated with intravenous fluconazole was observed over the six-month period after policy implementation. During this time, the rate of successful clinical outcomes for documented or suspected disseminated Candida albicansinfection or febrile neutropenia remained the same (66.6% prepolicy and 65.9% postpolicy; p = 0.95). Similarly, the number of deaths in patients receiving fluconazole remained unchanged (p = 0.31).
CONCLUSIONS:
A restriction policy for intravenous fluconazole results in significant cost savings, with no significant decrease in successful outcomes or change in mortality. |
| doi_str_mv | 10.1345/aph.10161 |
| format | Article |
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To evaluate both the economic and clinical impact of an intravenous fluconazole restriction policy in a university teaching hospital.
METHODS:
Intravenous fluconazole was restricted to patients unable to take oral medications due to significant nausea or to patients whose oral intake was restricted. A retrospective chart review and computerized record review was conducted in patients receiving intravenous or oral fluconazole from January 1 to June 30, 1997, and again from January 1 to June 30, 1998, after implementation of the policy.
RESULTS:
Six-month institutional expenditures for intravenous fluconazole decreased following policy implementation, from $81 900 to $45 400, an estimated annual institutional savings of $73 000. A 47% reduction in the number of patients treated with intravenous fluconazole was observed over the six-month period after policy implementation. During this time, the rate of successful clinical outcomes for documented or suspected disseminated Candida albicansinfection or febrile neutropenia remained the same (66.6% prepolicy and 65.9% postpolicy; p = 0.95). Similarly, the number of deaths in patients receiving fluconazole remained unchanged (p = 0.31).
CONCLUSIONS:
A restriction policy for intravenous fluconazole results in significant cost savings, with no significant decrease in successful outcomes or change in mortality.</description><identifier>ISSN: 1060-0280</identifier><identifier>EISSN: 1542-6270</identifier><identifier>DOI: 10.1345/aph.10161</identifier><identifier>PMID: 11197590</identifier><identifier>CODEN: APHRER</identifier><language>eng</language><publisher>Cincinnati, OH: SAGE Publications</publisher><subject>Administration, Oral ; Adult ; Aged ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antifungal agents ; Biological and medical sciences ; Cost-Benefit Analysis ; Drug Utilization Review - economics ; Drug Utilization Review - statistics & numerical data ; Female ; Fluconazole ; Guideline Adherence - economics ; Guideline Adherence - statistics & numerical data ; Humans ; Injections, Intravenous ; Male ; Medical sciences ; Middle Aged ; Organizational Policy ; Pharmacology. Drug treatments ; Treatment Outcome</subject><ispartof>The Annals of pharmacotherapy, 2001-01, Vol.35 (1), p.9-13</ispartof><rights>2001 SAGE Publications</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c340t-16b1af9e2d1b3970904a1ae7342f6a04875114827f1d7df0d281acb6e193107a3</citedby><cites>FETCH-LOGICAL-c340t-16b1af9e2d1b3970904a1ae7342f6a04875114827f1d7df0d281acb6e193107a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1345/aph.10161$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1345/aph.10161$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,4024,21819,27923,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=869558$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11197590$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Burkiewicz, Jill S</creatorcontrib><creatorcontrib>Kostiuk, Karen A</creatorcontrib><creatorcontrib>Jacobs, Richard A</creatorcontrib><creatorcontrib>Guglielmo, B Joseph</creatorcontrib><title>Impact of an Intravenous Fluconazole Restriction Policy on Patient Outcomes</title><title>The Annals of pharmacotherapy</title><addtitle>Ann Pharmacother</addtitle><description>OBJECTIVE:
To evaluate both the economic and clinical impact of an intravenous fluconazole restriction policy in a university teaching hospital.
METHODS:
Intravenous fluconazole was restricted to patients unable to take oral medications due to significant nausea or to patients whose oral intake was restricted. A retrospective chart review and computerized record review was conducted in patients receiving intravenous or oral fluconazole from January 1 to June 30, 1997, and again from January 1 to June 30, 1998, after implementation of the policy.
RESULTS:
Six-month institutional expenditures for intravenous fluconazole decreased following policy implementation, from $81 900 to $45 400, an estimated annual institutional savings of $73 000. A 47% reduction in the number of patients treated with intravenous fluconazole was observed over the six-month period after policy implementation. During this time, the rate of successful clinical outcomes for documented or suspected disseminated Candida albicansinfection or febrile neutropenia remained the same (66.6% prepolicy and 65.9% postpolicy; p = 0.95). Similarly, the number of deaths in patients receiving fluconazole remained unchanged (p = 0.31).
CONCLUSIONS:
A restriction policy for intravenous fluconazole results in significant cost savings, with no significant decrease in successful outcomes or change in mortality.</description><subject>Administration, Oral</subject><subject>Adult</subject><subject>Aged</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antifungal agents</subject><subject>Biological and medical sciences</subject><subject>Cost-Benefit Analysis</subject><subject>Drug Utilization Review - economics</subject><subject>Drug Utilization Review - statistics & numerical data</subject><subject>Female</subject><subject>Fluconazole</subject><subject>Guideline Adherence - economics</subject><subject>Guideline Adherence - statistics & numerical data</subject><subject>Humans</subject><subject>Injections, Intravenous</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Organizational Policy</subject><subject>Pharmacology. Drug treatments</subject><subject>Treatment Outcome</subject><issn>1060-0280</issn><issn>1542-6270</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkE1Lw0AURQdRbK0u_AMSEAQX0fcmH5NZSrFaLFRE1-F1MtGUZKbOJEL99aa22I2rdxeH-y6HsXOEG4zi5JZWHzcImOIBG2IS8zDlAg77DCmEwDMYsBPvlwAgkctjNkBEKRIJQ_Y0bVak2sCWAZlgalpHX9rYzgeTulPW0LetdfCifesq1VbWBM-2rtQ62CRqK23aYN61yjban7Kjkmqvz3Z3xN4m96_jx3A2f5iO72ahimJoQ0wXSKXUvMBFJAVIiAlJiyjmZUoQZyJBjDMuSixEUULBMyS1SDXKCEFQNGJX296Vs59dPy1vKq90XZPR_fJcQJIi8qwHr7egctZ7p8t85aqG3DpHyDfm8t5c_muuZy92pd2i0cWe3KnqgcsdQF5RXToyqvJ_XJbKJMn22zy963xpO2d6Ff_8-wGbtoEZ</recordid><startdate>200101</startdate><enddate>200101</enddate><creator>Burkiewicz, Jill S</creator><creator>Kostiuk, Karen A</creator><creator>Jacobs, Richard A</creator><creator>Guglielmo, B Joseph</creator><general>SAGE Publications</general><general>Whitney</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200101</creationdate><title>Impact of an Intravenous Fluconazole Restriction Policy on Patient Outcomes</title><author>Burkiewicz, Jill S ; Kostiuk, Karen A ; Jacobs, Richard A ; Guglielmo, B Joseph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c340t-16b1af9e2d1b3970904a1ae7342f6a04875114827f1d7df0d281acb6e193107a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Administration, Oral</topic><topic>Adult</topic><topic>Aged</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antifungal agents</topic><topic>Biological and medical sciences</topic><topic>Cost-Benefit Analysis</topic><topic>Drug Utilization Review - economics</topic><topic>Drug Utilization Review - statistics & numerical data</topic><topic>Female</topic><topic>Fluconazole</topic><topic>Guideline Adherence - economics</topic><topic>Guideline Adherence - statistics & numerical data</topic><topic>Humans</topic><topic>Injections, Intravenous</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Organizational Policy</topic><topic>Pharmacology. Drug treatments</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Burkiewicz, Jill S</creatorcontrib><creatorcontrib>Kostiuk, Karen A</creatorcontrib><creatorcontrib>Jacobs, Richard A</creatorcontrib><creatorcontrib>Guglielmo, B Joseph</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of pharmacotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Burkiewicz, Jill S</au><au>Kostiuk, Karen A</au><au>Jacobs, Richard A</au><au>Guglielmo, B Joseph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of an Intravenous Fluconazole Restriction Policy on Patient Outcomes</atitle><jtitle>The Annals of pharmacotherapy</jtitle><addtitle>Ann Pharmacother</addtitle><date>2001-01</date><risdate>2001</risdate><volume>35</volume><issue>1</issue><spage>9</spage><epage>13</epage><pages>9-13</pages><issn>1060-0280</issn><eissn>1542-6270</eissn><coden>APHRER</coden><abstract>OBJECTIVE:
To evaluate both the economic and clinical impact of an intravenous fluconazole restriction policy in a university teaching hospital.
METHODS:
Intravenous fluconazole was restricted to patients unable to take oral medications due to significant nausea or to patients whose oral intake was restricted. A retrospective chart review and computerized record review was conducted in patients receiving intravenous or oral fluconazole from January 1 to June 30, 1997, and again from January 1 to June 30, 1998, after implementation of the policy.
RESULTS:
Six-month institutional expenditures for intravenous fluconazole decreased following policy implementation, from $81 900 to $45 400, an estimated annual institutional savings of $73 000. A 47% reduction in the number of patients treated with intravenous fluconazole was observed over the six-month period after policy implementation. During this time, the rate of successful clinical outcomes for documented or suspected disseminated Candida albicansinfection or febrile neutropenia remained the same (66.6% prepolicy and 65.9% postpolicy; p = 0.95). Similarly, the number of deaths in patients receiving fluconazole remained unchanged (p = 0.31).
CONCLUSIONS:
A restriction policy for intravenous fluconazole results in significant cost savings, with no significant decrease in successful outcomes or change in mortality.</abstract><cop>Cincinnati, OH</cop><pub>SAGE Publications</pub><pmid>11197590</pmid><doi>10.1345/aph.10161</doi><tpages>5</tpages></addata></record> |
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| subjects | Administration, Oral Adult Aged Antibiotics. Antiinfectious agents. Antiparasitic agents Antifungal agents Biological and medical sciences Cost-Benefit Analysis Drug Utilization Review - economics Drug Utilization Review - statistics & numerical data Female Fluconazole Guideline Adherence - economics Guideline Adherence - statistics & numerical data Humans Injections, Intravenous Male Medical sciences Middle Aged Organizational Policy Pharmacology. Drug treatments Treatment Outcome |
| title | Impact of an Intravenous Fluconazole Restriction Policy on Patient Outcomes |
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