Therapeutics and Clinical Risk Management (Apr 2017)
Effectiveness of continuous improvement by a clinical pharmacist-led guidance team on the prophylactic antibiotics usage rationality in intervention procedure at a Chinese tertiary teaching hospital
Abstract
Ping Yang, Sai-Ping Jiang, Xiao-Yang Lu Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China Background: Irrational prophylactic antibiotics usage (PAU) during intervention procedures is common in China. A clinical pharmacist-led guidance team (CPGT) was established and participated in medical teams to advise on the rational usage of antibiotics.Objectives: The objective of this study was to assess the effectiveness of CPGT intervention for the rationality of PAU during intervention procedures.Method: This was a retrospective cross-sectional study with three stages at a Chinese tertiary teaching hospital. Patients who received some specific intervention procedures in the first quarter of 2015 were enrolled as the preintervention group, while those who received the procedures in the second and third quarters of 2015 were enrolled as the postintervention group. CPGT established the criteria for the PAU and conducted the intervention. The pre- and postintervention groups were then compared to evaluate the effectiveness of CPGTs’ sustained interventions.Results: A total of 651 patients were enrolled, with 200 patients in the preintervention group, while 233 patients and 218 patients in the first- and second-intervention groups, respectively. With the implementation of CPGTs continuous intervention, the rationality of PAU was significantly improved, including the timing (91.98% vs 97.74%, P=0.015), duration (82.72% vs 98.31%, P<0.0001), and choice (81.48% vs 93.22%, P=0.001) of antibiotics administered during perioperative period. Moreover, the cost of total (US$34.89±80.96 vs US$9.81±26.31, P=0.025) and inappropriate PAU (US$28.75±73.27 vs US$3.57±14.62, P<0.0001) per patient was significantly reduced.Conclusion: CPGTs’ continuous intervention significantly improved the rationality of PAU during intervention procedures, with a significant reduction in antibiotic cost. Keywords: intervention procedures, prophylactic antibiotics usage, clinical pharmacist-led guidance teams’ intervention, prescription evaluation
