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Clinical Guidelines and Pharmacist Intervention Program for HIV‐Infected Patients Requiring Granulocyte Colony‐Stimulating Factor Therapy
Author(s) -
EnglesHorton Laura L.,
Skowronski Carolyn,
Mostashari Farzad,
Altice Frederick L.
Publication year - 1999
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.19.4.356.30938
Subject(s) - medicine , pharmacy , clinical pharmacy , pharmacist , granulocyte colony stimulating factor , psychological intervention , neutropenia , human immunodeficiency virus (hiv) , emergency medicine , pediatrics , immunology , family medicine , chemotherapy , nursing
Guidelines, implemented by clinical pharmacists, were developed by the pharmacy and therapeutics subcommittee on a dedicated service caring for hospitalized patients with human immunodeficiency virus infection or the acquired immunodeficiency syndrome (AIDS) who required granulocyte colony‐stimulating factor (G‐CSF) therapy. Drug use and evaluation was conducted on all patients with AIDS who were prescribed G‐CSF, and education was provided to medical house staff. Clinical data from chart review and laboratory and billing data bases of the hospital medical information system were compared for the 9‐month intervention period (IP) with data from the 9‐month preintervention period (PIP). Comparing the IP and PIP, the mean number of G‐CSF doses (0.29 vs 0.51) and pharmacy costs per day ($112 vs $200) decreased, with no change in the number of patients requiring G‐CSF. The 1.3 pharmacist interventions per patient resulted in a decrease to 2.4 doses per admission from a baseline of 5.9 (p<0.0001). Mean hospital stay (11.9 vs 13.8 days) and mean number of days of neutropenia did not differ for IP and PIP groups. Effectively implemented pharmacist‐based interventions can decrease hospital costs without increasing patient morbidity.