PMID- 19468008
OWN - NLM
STAT- MEDLINE
DCOM- 20090824
LR  - 20191210
IS  - 1475-3901 (Electronic)
IS  - 1475-3898 (Linking)
VI  - 18
IP  - 3
DP  - 2009 Jun
TI  - Long-term effects of a multifaceted intervention to encourage the choice of the 
      oral route for proton pump inhibitors: an interrupted time-series analysis.
PG  - 232-5
LID - 10.1136/qshc.2007.023887 [doi]
AB  - PROBLEM: Drugs are often given intravenously even when the patient is able to 
      swallow and when an oral form would be more cost-effective. DESIGN: Evaluation of 
      the impact of a multifaceted intervention on the early switch from intravenous to 
      oral administration of proton pump inhibitors (PPI) in a hospital setting. The 
      interrupted time series of intravenous PPI consumption was analysed. BACKGROUND 
      AND SETTING: At a French University Hospital, the Drug Committee, composed of 
      multidisciplinary pharmacy and medical staff, addressed the issue of increasing 
      consumption of intravenous PPI drugs (May 2003). STRATEGY FOR CHANGE: Letters to 
      department heads, academic analyses from members of the Drug Committee, paper 
      reminders at the point of care and audit-feedbacks by pharmacists. Monitoring of 
      consumption and repeated reminder letters were planned. EFFECT OF CHANGE: The 
      consumption of PPI was stable before the first intervention (mean level: 954 
      units/month). An immediate decrease occurred after the first Drug Committee 
      letter (30% relative reduction, 95% CI -16% to -46%; p<0.001) with a significant 
      trend change during the first multifaceted intervention (-24 units/month, 95% CI 
      -42 to -7; p = 0.007). After the end of the outreach visits (July 2004), the 
      consumptions increased (+32 units/month, 95% CI: 14 to 50, p<0.001). The second 
      intervention had no significant impact. LESSONS LEARNT: A complex intervention 
      (audit, feedbacks, outreach visits) had an effect on practice. It was not 
      sustained even after a less resource-intensive intervention. Other types of 
      interventions are needed that could be continuously implemented to improve 
      ordering practices long term.
FAU - Colombet, I
AU  - Colombet I
AD  - INSERM, UMR_S 872, Paris, France. isabelle.colombet@egp.aphp.fr
FAU - Sabatier, B
AU  - Sabatier B
FAU - Gillaizeau, F
AU  - Gillaizeau F
FAU - Prognon, P
AU  - Prognon P
FAU - Begue, D
AU  - Begue D
FAU - Durieux, P
AU  - Durieux P
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - England
TA  - Qual Saf Health Care
JT  - Quality & safety in health care
JID - 101136980
RN  - 0 (Proton Pump Inhibitors)
MH  - Administration, Oral
MH  - France
MH  - Guideline Adherence
MH  - Humans
MH  - Infusions, Intravenous
MH  - Practice Patterns, Physicians'/*statistics & numerical data
MH  - Proton Pump Inhibitors/*administration & dosage
MH  - Reminder Systems
EDAT- 2009/05/27 09:00
MHDA- 2009/08/25 09:00
CRDT- 2009/05/27 09:00
PHST- 2009/05/27 09:00 [entrez]
PHST- 2009/05/27 09:00 [pubmed]
PHST- 2009/08/25 09:00 [medline]
AID - 18/3/232 [pii]
AID - 10.1136/qshc.2007.023887 [doi]
PST - ppublish
SO  - Qual Saf Health Care. 2009 Jun;18(3):232-5. doi: 10.1136/qshc.2007.023887.