Use of histamine2-receptor blocking agents and sucralfate in a health maintenance organization following continued clinical pharmacist intervention

The effect of continued clinical pharmacist intervention on the proper use of histamine2-receptor blocking agents and sucralfate in a health maintenance organization was studied. New prescriptions written for cimetidine, famotidine, ranitidine, and sucralfate in January 1986 (preintervention), October 1986 (postintervention), and February 1987 (follow-up), and the medical record of each patient were analyzed for appropriateness using approved criteria. Clinical pharmacist intervention occurred throughout the study. There was a significant decrease (p less than 0.005) in the rate of inappropriate prescribing in the postintervention (42.4 percent) and follow-up (48.7 percent) periods versus the preintervention period (81.5 percent), and in the average number of refills authorized per patient in the postintervention (1.2 +/- 1.54) and follow-up (1.3 +/- 1.00) periods versus the preintervention period (3.0 +/- 3.67). There were no significant differences in these areas between the postintervention and follow-up periods (p greater than 0.05). A benefit-to-cost ratio of 4.3:1 was generated from this study which demonstrated that continued clinical pharmacy interventions can have a positive, cost-effective impact on the proper use of these commonly prescribed medications.