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HSR&D 2004 National Meeting Abstracts


2036. Informing Clinicians About Drug Interactions May Reduce Healthcare Costs
Pamela S Belperio, PharmD, VA HSR&D Center of Excellence for the Study of Healthcare Povider Behavior, VA Greater Los Angeles Healthcare System-West Los Angeles, PA Glassman, VA HSR&D Center of Excellence for the Study of Healthcare Povider Behavior, VA Greater Los Angeles Healthcare System-West Los Angeles and UCLA, B Simon, VA HSR&D Center of Excellence for the Study of Healthcare Povider Behavior, VA Greater Los Angeles Healthcare System-West Los Angeles and Sepulveda, A Lanto, VA HSR&D Center of Excellence for the Study of Healthcare Povider Behavior, VA Greater Los Angeles Healthcare System-West Los Angeles and Sepulveda

Objectives: Preventing drug interactions, which lead to adverse drug events (ADEs), may lead to lower healthcare costs. We assessed whether provider feedback concerning potential medication interactions would result in reduced healthcare costs.

Methods: We randomized 938 ambulatory patients to either provider feedback about potential drug interactions (intervention group) or to usual care (control group) using a computerized retrospective drug utilization (DUR) system. Biweekly, from June 2001 through January 2002, we randomized 60 patients with unique, active drug interactions and sent feedback letters to providers of intervention patients. We used Decision Support Services tools to measure total outpatient costs (pharmacy, lab, radiology, and visits) and total hospitalizations costs.

Results: Providers for patients in the intervention group were sent a total of 1053 letters. Economic data was available for 97% of all selected patients. Total intervention group outpatient costs ($2.99 M) were significantly less than for the control group ($3.85M), with average total cost per patient of $5905 vs. $7471 (P= 0.029). Intervention group average pharmacy expenses were also less but did not reach statistical significance ($1343 vs.$1417, P = 0.62). However, DUR system automated review indicated that changes to target medications were similar in each group (79% vs. 82%, 95%CI of difference, 1.7 to 7.7%)

Conclusions: Health care costs in the intervention group are lower when providing feedback on potential medication interactions, above and beyond what occurs with provider order entry.

Impact: Further analysis will be conducted to determine the true relationship between notification of potential interactions, lower occurrence of ADEs, and reduced healthcare costs.