Premium
Clinical and Economic Outcomes of Pharmacist‐Managed Antiepileptic Drug Therapy
Author(s) -
Bond C. A.,
Raehl Cynthia L.
Publication year - 2006
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.26.10.1369
Subject(s) - medicine , pharmacist , odds ratio , pharmacy , epilepsy , confidence interval , population , adverse effect , clinical pharmacy , emergency medicine , pharmacotherapy , pediatrics , psychiatry , family medicine , environmental health
This study explores the associations between pharmacist‐managed antiepileptic drug therapy in hospitalized Medicare patients and diagnoses indicating the need for these drugs. It also explores the following major heath care outcomes: death rate, hospital length of stay (LOS), Medicare charges, drug charges, laboratory charges, complications, and adverse drug reactions. Data were drawn from the 1998 MedPAR and 1998 National Clinical Pharmacy Services databases. Pharmacist‐managed antiepileptic drug therapy was evaluated in a study population of 9380 Medicare patients with diagnosed epilepsy or seizure disorders treated in 794 United States hospitals. This population was derived from the 38,311 hospitalized Medicare patients with epilepsy or seizure disorders (MedPAR). In hospitals without pharmacist‐managed antiepileptic drug therapy, death rates were 120.61% higher, with 374 excess deaths (χ 2 =5.983, df =1, p=0.014, odds ratio [OR]=1.553, 95% confidence interval [CI] 1.102–2.189). Hospital LOS was 14.68% higher, with 8069 patient‐days (Mann‐Whitney U test [U]=3833132, p=0.0009); total Medicare charges were 11.19% higher, with $14,372,550 in excess total charges (U=3644199, p=0.0003); per‐patient drug charges were $115 ± $92 higher (p=NS); laboratory charges were 32.24% higher, with $5,664,970 in excess charges; and aspiration pneumonia rate was 54.61% higher (χ 2 =5.848, df = 1, p=0.015, OR=1.233, 95% CI 1.081–1.901). Although the frequencies of other complications and adverse effects were higher, these differences were not statistically significant compared with hospitals with pharmacist‐managed antiepileptic drug therapy. Clinical and economic outcomes were improved among hospitalized Medicare patients whose antiepileptic drug therapy was managed by pharmacists.