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Computerized Reminders Reduce the Use of Medications during Shortages

Affiliations of the authors: Division of Critical Care Medicine (BB, BRJ) and Pharmacy Department (JH), Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH.

Correspondence and reprints: Brian R. Jacobs, MD, Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229; e-mail: <jacobs{at}chmcc.org>.

Received for publication: 01/09/04; accepted for publication: 03/14/04.

Medication shortages pose serious problems in health care. This study examines the impact of a computer-based reminder in addressing a national methylprednisolone shortage. An alert was designed and implemented in a computerized order entry platform at a children's hospital. The alert informed physicians of the shortage and provided an alternative prescribing pathway. Data regarding the number and type of parenteral corticosteroid prescriptions were collected for a one-month period before and after the alert was implemented. The alert resulted in a 55% relative reduction in methylprednisolone use and an average reduction of more than three orders each day. Dexamethasone and hydrocortisone, the recommended alternative medications, increased in use by 12% and 49%, respectively. The alert resulted in a $36,552 annualized cost reduction to the institution. Similar alert applications have great potential for effectively altering physician prescribing behavior.