Evaluation of a protocol‐based intervention to promote timely switching from intravenous to oral paracetamol for post‐operative pain management: an interrupted time series analysis

Sabry, Nirmeen, Dawoud, Dalia, Alansary, Adel, Hounsome, Natalia and Baines, Darrin (2015) Evaluation of a protocol‐based intervention to promote timely switching from intravenous to oral paracetamol for post‐operative pain management: an interrupted time series analysis. Journal of Evaluation in Clinical Practice, 21 (6). pp. 1081-1088. ISSN 1356-1294

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Abstract

Rationale, aims and objectives
Timely switching from intravenous to oral therapy ensures optimized treatment and efficient use of health care resources. Intravenous (IV) paracetamol is widely used for post‐operative pain management but not always switched to the oral form in a timely manner, leading to unnecessary increase in expenditure. This study aims to evaluate the impact of a multifaceted intervention to promote timely switching from the IV to oral form in the post‐operative setting.

Methods
An evidence‐based prescribing protocol was designed and implemented by the clinical pharmacy team in a single district general hospital in Egypt. The protocol specified the criteria for appropriate prescribing of IV paracetamol. Doctors were provided with information and educational sessions prior to implementation. A prospective, quasi‐experimental study was undertaken to evaluate its impact on IV paracetamol utilization and costs. Data on monthly utilization and costs were recorded for 12 months before and after implementation (January 2012 to December 2013). Data were analysed using interrupted time series analysis.

Results
Prior to implementation, in 2012, total spending on IV paracetamol was 674 154.00 Egyptian Pounds (L.E.) ($23 668.00). There was a non‐significant (P > 0.05) downward trend in utilization (−32 ampoules per month) and costs [reduction of 632 L.E. ($222) per month]. Following implementation, immediate decrease in utilization and costs (P < 0.05) and a trend change over the follow‐up period were observed. Average monthly reduction was 26% (95% CI: 24% to 28%, P < 0.001).

Conclusion
A multifaceted, protocol‐based intervention to ensure timely switching from IV‐to‐oral paracetamol achieved significant reduction in utilization and cost of IV paracetamol in the first 5 months of its implementation.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Global Health and Infection
Research Centres and Groups: Wellcome Trust Brighton and Sussex Centre for Global Health Research
Depositing User: emma louise Bertrand
Date Deposited: 14 Sep 2018 08:32
Last Modified: 14 Sep 2018 08:32
URI: http://sro.sussex.ac.uk/id/eprint/78744
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