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Okumura LM, Veroneze I, Burgardt CI, et al. Effects of a computerized provider order entry and a clinical decision support system to improve cefazolin use in surgical prophylaxis: a cost saving analysis. Pharm Pract (Granada). 2016;14(3):717doi: 10.18549/PharmPract.2016.03.717.
Okumura, L. M., Veroneze, I., Burgardt, C. I., & Fragoso, M. F. (2016). Effects of a computerized provider order entry and a clinical decision support system to improve cefazolin use in surgical prophylaxis: a cost saving analysis. Pharmacy practice, 14(3), 717. https://doi.org/10.18549/PharmPract.2016.03.717
Okumura, Lucas M, et al. "Effects of a computerized provider order entry and a clinical decision support system to improve cefazolin use in surgical prophylaxis: a cost saving analysis." Pharmacy practice vol. 14,3 (2016): 717. doi: https://doi.org/10.18549/PharmPract.2016.03.717
Okumura LM, Veroneze I, Burgardt CI, Fragoso MF. Effects of a computerized provider order entry and a clinical decision support system to improve cefazolin use in surgical prophylaxis: a cost saving analysis. Pharm Pract (Granada). 2016 Jul-Sep;14(3):717. doi: 10.18549/PharmPract.2016.03.717. Epub 2016 Sep 15. PMID: 27785159; PMCID: PMC5061515.
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Pharm Pract (Granada). 2016 Jul-Sep;14(3):717. doi: 10.18549/PharmPract.2016.03.717. Epub 2016 Sep 15.

Effects of a computerized provider order entry and a clinical decision support system to improve cefazolin use in surgical prophylaxis: a cost saving analysis.

Pharmacy practice

Lucas M Okumura, Izelandia Veroneze, Celia I Burgardt, Marta F Fragoso

Affiliations

  1. Clinical Pharmacy Division, Porto Alegre Clinical Hospital. Porto Alegre, RS ( Brazil ). [email protected].
  2. Infection Control Service, Clinical Hospital, Federal University of Paraná . Curitiba, PR ( Brazil ). [email protected].
  3. Infection Control Service, Clinical Hospital, Federal University of Paraná . Curitiba, PR ( Brazil ). [email protected].
  4. Infection Control Service, Clinical Hospital, Federal University of Paraná . Curitiba, PR ( Brazil ). [email protected].

PMID: 27785159 PMCID: PMC5061515 DOI: 10.18549/PharmPract.2016.03.717

Abstract

BACKGROUND: Computerized Provider Order Entry (CPOE) and Clinical Decision Support System (CDSS) help practitioners to choose evidence-based decisions, regarding patients' needs. Despite its use in developed countries, in Brazil, the impact of a CPOE/CDSS to improve cefazolin use in surgical prophylaxis was not assessed yet.

OBJECTIVE: We aimed to evaluate the impact of a CDSS to improve the use of prophylactic cefazolin and to assess the cost savings associated to inappropriate prescribing.

METHODS: This is a cross-sectional study that compared two different scenarios: one prior CPOE/CDSS versus after software implementation. We conducted twelve years of data analysis (3 years prior and 9 years after CDSS implementation), where main outcomes from this study included: cefazolin Defined Daily Doses/100 bed-days (DDD), crude costs and product of costs-DDD (cost-DDD/100 bed-days). We applied a Spearman rho non-parametric test to assess the reduction of cefazolin consumption through the years.

RESULTS: In twelve years, 84,383 vials of cefazolin were dispensed and represented 38.89 DDD/100 bed-days or USD 44,722.99. Surgical wards were the largest drug prescribers and comprised >95% of our studied sample. While in 2002, there were 6.31 DDD/100 bed-days, 9 years later there was a reduction to 2.15 (p<0.05). In a scenario without CDSS, the hospital would have consumed 75.72 DDD/100 bed-days, which is equivalent to USD 116 998.07. It is estimated that CDSS provided USD 50,433.39 of cost savings.

CONCLUSION: The implementation of a CPOE/CDSS helped to improve prophylactic cefazolin use by reducing its consumption and estimated direct costs.

Keywords: Anti-Bacterial Agents; Brazil; Clinical; Clinical Pharmacy Information Systems; Cost Savings; Decision Support Systems; Hospitals; Medical Order Entry Systems; Pharmacists

Conflict of interest statement

None to declare. LMO received a monthly scholarship from the Brazilian Ministry of Education, as PGY4 Pediatrics Pharmacy Resident from “Residência Integrada Multiprofissional em Saúde (Hospital de Cl

References

  1. J Antimicrob Chemother. 2002 Mar;49(3):567-71 - PubMed
  2. J Am Med Inform Assoc. 2015 Jan;22(1):236-42 - PubMed
  3. Clin Med (Lond). 2014 Aug;14(4):338-41 - PubMed
  4. N Engl J Med. 2011 Dec 1;365(22):2045-7 - PubMed
  5. Am J Infect Control. 2016 Sep 1;44(9):e145-52 - PubMed
  6. South Med J. 1980 Nov;73(11):1473-5 - PubMed
  7. Braz J Infect Dis. 2013 Jan-Feb;17(1):48-53 - PubMed
  8. Emerg Infect Dis. 2005 Jun;11(6):794-801 - PubMed
  9. Ann Intern Med. 1996 May 15;124(10):884-90 - PubMed
  10. Int J Infect Dis. 2013 Dec;17(12):e1212-7 - PubMed
  11. Clin Infect Dis. 2005 Aug 15;41 Suppl 4:S283-6 - PubMed
  12. Clin Infect Dis. 2014 Jul 15;59(2):e10-52 - PubMed
  13. Am J Hosp Pharm. 1978 Dec;35(12):1521-3 - PubMed
  14. J Am Med Inform Assoc. 2001 Nov-Dec;8(6):527-34 - PubMed
  15. Am J Health Syst Pharm. 2013 Feb 1;70(3):195-283 - PubMed
  16. Braz J Infect Dis. 2015 May-Jun;19(3):246-52 - PubMed

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