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PHYSICIANS’
ACCEPTANCE OF A PREFORMATTED PHARMACY INTERVENTION CHART NOTE IN A COMMUNITY
HOSPITAL ANTIBIOTIC STEP-DOWN PROGRAM
Scot E Walker
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OBJECTIVE: To determine whether physicians would accept a preformatted written pharmacy intervention note suggesting a change in a patient’s drug and route of administration.
DESIGN: Open-label, randomized study.
SETTING: Nonacademic community hospital.
PATIENTS: Fifty non-intensive-care inpatients with community-acquired pneumonia who were receiving intravenous ceftriaxone.
INTERVENTION: Physicians of patients in the pharmacy intervention group (n = 25) received a written recommendation to change intravenous ceftriaxone to oral cefpodoxime.
MAIN OUTCOME MEASURES: Both groups were compared for the number of patients converted to oral therapy and the occurrence of readmission.
RESULTS: Patients whose physicians received an intervention chart note were switched to oral therapy in 88% of cases, compared with 36% in the control group (p = 0.000331). There was no statistical difference between groups in the number of readmissions.
CONCLUSIONS: The results of this study suggest that a preformatted pharmacy intervention note can affect physician prescribing practices for patients with pneumonia in an intravenous-to-oral step-down program. This would be beneficial in nonacademic community hospitals, where direct contact with physicians is not always possible.
J Pharm Technol 1998;14:141-45.
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