Outcomes of a decision support prompt in community pharmacy-dispensing software to promote step-down of proton pump inhibitor therapy

Br J Clin Pharmacol. 2011 May;71(5):780-4. doi: 10.1111/j.1365-2125.2010.03890.x.

Abstract

Aim: To evaluate the effect of a computerized decision support prompt regarding high-dose proton pump inhibitor (PPI) therapy on prescribing and medication costs.

Methods: A prompt activated on dispensing high-dose esomeprazole or pantoprazole was implemented in 73 of 185 pharmacies. Anonymized prescription data and a patient survey were used to determine changes in prescribing and associated medication costs.

Results: The pharmacist-recorded PPI intervention rate per 100 high-dose PPI prescriptions was 1.67 for the PPI prompt group and 0.17 for the control group (P < 0.001). During the first 28 days of the trial, 196 interventions resulted in 34 instances of PPI step-down, with 28 of these occurring in PPI prompt pharmacies. Cost savings attributable to the prompt were AUD 7.98 (£4.95) per month per PPI prompt pharmacy compared with AUD 1.05 (£0.65) per control pharmacy.

Conclusion: The use of electronic decision support prompts in community pharmacy practice can promote the quality use of medicines.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Australia
  • Community Pharmacy Services* / economics
  • Decision Support Techniques*
  • Drug Costs / statistics & numerical data
  • Drug Prescriptions / economics
  • Drug Prescriptions / standards
  • Drug Prescriptions / statistics & numerical data
  • Drug Therapy, Computer-Assisted / economics
  • Drug Therapy, Computer-Assisted / methods*
  • Humans
  • Outcome Assessment, Health Care
  • Proton Pump Inhibitors / administration & dosage*
  • Proton Pump Inhibitors / economics
  • Proton Pump Inhibitors / therapeutic use
  • Software

Substances

  • Proton Pump Inhibitors