Elenbaas R M, Payne V W, Bauman J L
Am J Hosp Pharm. 1980 Jan;37(1):61-4.
The effect of a controlled-ordering program (prior authorization by a clinical pharmacist) on the number and cost of drug blood level assays performed at the Truman Medical Center (Kansas City, MO) was studied. Drug assay orders for aminoglycosides, phenobarbital, phenytoin, quinidine, theophylline, salicylate, thiocyanate, and propranolol, laboratory costs, and hospital census were reviewed retrospectively. The programs compared were: (1) control (July to December 1977)--drug blood level assays were ordered at physicians' discretion, and (2) study (January 16, 1978 to January 15, 1979)--all pharmacokinetic assays had to be approved by a pharmacist. A significant (p less than 0.001) reduction in the number of assays performed per month (40%) and in the assay cost per month (44%) occurred during the study period. The program was estimated to save $12,086.61 annually. The policy of requiring pharmacist approval of drug assay orders reduced the improper use and cost of pharmacokinetic monitoring.
研究了一项控量程序（由临床药剂师进行预先授权）对在杜鲁门医疗中心（密苏里州堪萨斯城）进行的药物血药浓度检测数量和成本的影响。回顾性审查了氨基糖苷类、苯巴比妥、苯妥英、奎尼丁、茶碱、水杨酸盐、硫氰酸盐和普萘洛尔的药物检测订单、实验室成本和医院普查情况。所比较的方案为：（1）对照（1977年7月至12月）——药物血药浓度检测由医生自行决定下达，以及（2）研究（1978年1月16日至1979年1月15日）——所有药代动力学检测必须经药剂师批准。在研究期间，每月进行的检测数量显著减少（40%），每月的检测成本显著降低（44%）（p<0.001）。据估计，该程序每年可节省12,086.61美元。要求药剂师批准药物检测订单的政策减少了药代动力学监测的不当使用和成本。
