Lois Coulter

Effects of pharmacy resident led education on resident physician prescribing habits associated with stress ulcer prophylaxis in non-intensive care unit patients

OBJECTIVE Overutilization of stress ulcer prophylaxis in both critically and noncritically ill patients poses significant health risks and increases healthcare costs. The purpose of this study was to assess the impact of education for appropriate stress ulcer prophylaxis prescribing by Family Medicine Resident Physicians. METHODS The study evaluated the SUP prescribing and continuation or discontinuation of acid suppressive therapy upon discharge. Patients admitted to the Family Medicine Residency team at Washington Regional Medical Center were retrospectively assessed from September through November 2011. In January 2012, an educational seminar describing appropriate stress ulcer prophylaxis indications, the associated risks and costs of acid suppressive therapy, and initial findings was provided. After the educational intervention, patients admitted to the Family Medicine Residency team were retrospectively followed from February through April 2012 to assess the impact of the educational intervention. RESULTS Post education analysis demonstrated a decrease in inappropriate stress ulcer prophylaxis prescribing from 55.5% to 30.5% (p < 0.0001). There was no statistically significant difference between the pre-intervention (5.5%) and post-intervention (8.3%) groups in regards to patients discharged on AST inappropriately (p = 0.627). CONCLUSION Pharmacist led educational sessions improved appropriateness of stress ulcer prophylaxis prescribing by Family Practice Resident Physicians, leading to patient risk avoidance and cost savings..

Screening for diabetes in patients receiving second-generation atypical antipsychotics

PURPOSE Results of a study to assess adherence with a consensus statement for diabetes screening in patients receiving atypical antipsychotics and to evaluate the role of pharmacists in a patient-centered medical home in improving guideline adherence are presented. SUMMARY For patients prescribed atypical antipsychotics, records were reviewed for glycosylated hemoglobin (HbA1c) testing within the past 12 months. If no HbA1c results were found within that time frame, physicians were sent an alert in the patients electronic medical record requesting an HbA1c order. Patient medical records were reviewed to analyze the number of HbA1c orders before and after pharmacist intervention. Prior to pharmacist intervention, 17 of 120 (14%) patients were screened with HbA1c. As a result of pharmacist intervention, 86 alerts were sent to physicians to order an HbA1c level, 24 (28%) of which included an order for an HbA1c level. Eleven of 24 (46%) HbA1c test results were collected during study follow-up, and one prediabetic patient was identified. CONCLUSION After pharmacist intervention, a greater number of patients receiving atypical antipsychotic medications had HbA1c levels monitored for evidence of type 2 diabetes.