Students Research in Progress
Sunday, November 12, 2023
12:45 PM–02:15 PM
Abstract
Introduction: Drug shortages have become a challenging problem to navigate in healthcare, with many critical shortages over the past 12 months.1 Strategies and workflows are needed within a health system to address shortage mitigation and conservation plans to ensure availability for those with the greatest need. At Nebraska Medicine, EPIC order alerts (Legacy Medication Alternatives, LMAs) are utilized as a tool to mitigate shortages. The LMA can be a “soft stop” or “hard stop”. Soft stop LMAs provide shortage information and recommend alternative therapies, but the ordering provider can override the message to choose the desired medication. Hard stop LMAs also provides information and recommended alternatives, but the ordering provider is unable to bypass the alert and must choose an alternative or contact a pharmacist to order the shortage medication, if an alternative is not appropriate.
LMAs are not utilized outside of shortages at Nebraska Medicine, due to the concern of alert fatigue.
Research Question or Hypothesis: What is the impact of utilizing LMAs as a drug shortage mitigation strategy, and could LMAs be a useful tool to guide drug therapy and formulary management for select medications without adding to alert fatigue?
Study Design: Retrospective, pre-post cohort study
Methods: Three critical drug shortages were reviewed to evaluate the impact of utilizing LMAs as a mitigation strategy: 1) albuterol, albuterol-ipratropium, and ipratropium nebulization solutions, 2) oxycodone 5 mg tablets, and 3) intravenous corticosteroids. Weekly utilization data were tracked using EPIC data for each medication and their alternatives. Baseline average weekly utilization was calculated using utilization data for 12 months prior to each shortage. Average percent change from baseline in weekly utilization was calculated for 1 and 4-weeks after LMA was implemented for all the medications on shortage with soft and hard stop LMAs and their key alternatives.
Results: In-progress
Conclusion: In-progress
Presenting Author
Makinzie Vandewege PharmD CandidateUniversity of Nebraska Medical Center
Authors
Sara Kjerengtroen PharmD, BCPS
Nebraska Medicine
Jenel Proksel PharmD, BCPS
Nebraska Medicine