Leena H Saeed
King Saud Medical City Saudi Arabia
Posters & Accepted Abstracts: J Neurosci Neuropharm
Background: In each hospital, there are good number of patients who are candidates
for the switch-over from intravenous (IV) to oral therapy. The main hindrance
that restricts intravenous to oral conversion is the idea that oral medications do
not reach the same bioavailability as that of intravenous medications and that the
same item must be used both intravenously and orally. Although several drugs
commonly used in hospitalized patients are equally bioavailable intravenously
and orally, patients usually are not shifted to the oral medication when stable and
taking oral medications or eating an oral diet. There are many advantages involved
in earlier conversion from the intravenous to the oral therapy, including but not
conclusive to less nursing time for medication administration, lower cost, less
intravenous catheters needed can lead to increased patient satisfaction and safety.
Objective: Establishment of a pharmacist-led IV to oral switch over protocol in
the National Neuroscience Institute (NNI) at King Fahad Medical City (KFMC),
in an attempt to reduce the annual medication cost.
Method: The study was conducted in the NNI of KFMC in Riyadh Saudi Arabia.
The study was prospective. We identified five targeted medications that are
commonly prescribed in NNI (NHDU, NW1, Stroke) inpatient wards with almost
identical oral and intravenous bioavailability. Fort five (45) patients were recruited.
Their files were reviewed by the pharmacist and recommendation to switch was
communicated to physician either verbally or documented in the patient file. The
total cost of the medications was compared between oral and intravenous forms
according to the length of stay in the ward. Inclusion and exclusion criteria are
mentioned. Difference between oral and IV medication cost were compared using
Mann-Whitney U test. All data entry and statistical analyses were performed
using SPSS 22.0 software.
Results: This study has been in place for six months. Seventy one (71)
recommendations were made. Of these recommendations, 11 (15.5%) were
rejected and 60 (84.5%) were accepted and implemented, resulting in a cost
savings of 10,652 SAR (P=0.001). When annualized, the expected savings is 21,304
SAR or nearly the monthly salary of two full-time pharmacists.
Conclusion: This study demonstrates successful implementation of a pharmacistled
switch-over strategy. Duration of IV treatment reduced dramatically and the
annual savings significantly improved. This program has been well accepted by
physicians and pharmacists. It appears to be having a positive impact on physician
awareness of using oral medications when appropriate. This study may be used as
a template for the introduction of further pharmacist-led early IV to oral switchover
initiatives.
E-mail: ph.leena@hotmail.com
