James M Camamo1, Kurt Weibel2, Terence O'Keeffe3, Yvonne Huckleberry2, Brian J Kopp2, Conrad Diven3, Brian L Erstad2. 1. University of Arizona Medical Center, Department of Pharmacy Services, Tucson, AZ; The University of Arizona College of Pharmacy, Department of Pharmacy Practice and Science, Tucson, AZ. Electronic address: james.camamo@uahealth.com. 2. University of Arizona Medical Center, Department of Pharmacy Services, Tucson, AZ; The University of Arizona College of Pharmacy, Department of Pharmacy Practice and Science, Tucson, AZ. 3. University of Arizona Medical Center, Department of Pharmacy Services, Tucson, AZ; The University of Arizona College of Medicine, Tucson, AZ.
Abstract
PURPOSE: The purpose of this evaluation is to describe the cost savings associated with multimodal interventions aimed at reducing aerosolized bronchodilator use in mechanically ventilated patients without adversely affecting costs associated with length of stay (LOS). MATERIALS AND METHODS: Subjects were included in the analysis if they were aged more than 18 years, on mechanical ventilation in the intensive care unit, and received aerosolized bronchodilators. Patients were excluded if they had reversible airway disease, an indication needing bronchodilator therapy. Patient data were obtained using the University Health System Consortium Clinical Data Base/Resource Manager (Chicago, IL) to compare outcomes during two 6-month periods separated by a 4-month intervention phase aimed to reduce bronchodilator use. RESULTS: There were no significant differences in age, sex, and LOS (observed and expected) between the preintervention and postintervention phases. Based on whole acquisition costs, the total cost of bronchodilators dispensed to the adult intensive care units over the 6-month postintervention phase was reduced by $56960 compared with the 6-month preintervention phase ($120562 vs $63602, respectively). CONCLUSIONS: Multimodal efforts to restrict aerosolized bronchodilator therapy in mechanically ventilated patients were successful and led to sustained reductions in use that was associated with substantial reductions in cost, without affecting LOS.
PURPOSE: The purpose of this evaluation is to describe the cost savings associated with multimodal interventions aimed at reducing aerosolized bronchodilator use in mechanically ventilated patients without adversely affecting costs associated with length of stay (LOS). MATERIALS AND METHODS: Subjects were included in the analysis if they were aged more than 18 years, on mechanical ventilation in the intensive care unit, and received aerosolized bronchodilators. Patients were excluded if they had reversible airway disease, an indication needing bronchodilator therapy. Patient data were obtained using the University Health System Consortium Clinical Data Base/Resource Manager (Chicago, IL) to compare outcomes during two 6-month periods separated by a 4-month intervention phase aimed to reduce bronchodilator use. RESULTS: There were no significant differences in age, sex, and LOS (observed and expected) between the preintervention and postintervention phases. Based on whole acquisition costs, the total cost of bronchodilators dispensed to the adult intensive care units over the 6-month postintervention phase was reduced by $56960 compared with the 6-month preintervention phase ($120562 vs $63602, respectively). CONCLUSIONS: Multimodal efforts to restrict aerosolized bronchodilator therapy in mechanically ventilated patients were successful and led to sustained reductions in use that was associated with substantial reductions in cost, without affecting LOS.
Authors: David M P van Meenen; Sophia M van der Hoeven; Jan M Binnekade; Corianne A J M de Borgie; Maruschka P Merkus; Frank H Bosch; Henrik Endeman; Jasper J Haringman; Nardo J M van der Meer; Hazra S Moeniralam; Mathilde Slabbekoorn; Marcella C A Muller; Willemke Stilma; Bart van Silfhout; Ary Serpa Neto; Hans F M Ter Haar; Jan Van Vliet; Jan Willem Wijnhoven; Janneke Horn; Nicole P Juffermans; Paolo Pelosi; Marcelo Gama de Abreu; Marcus J Schultz; Frederique Paulus Journal: JAMA Date: 2018-03-13 Impact factor: 56.272