Economic Evaluation of Pharmacist’s Antimicrobial Stewardship Interventions Through Integrated Electronic Health Record System in a Cardiac Care Facility

OBJECTIVES: The primary objective of this study is to conduct an economic analysis of pharmacist interventions on antimicrobial usage within a hospital setting, utilizing advanced integrated electronic health record systems with clinical decision support features

METHODS: A retrospective study was conducted in a cardiac care hospital from the inception of antimicrobial stewardship program through electronic health record system i.e. May 2019 to May 2020. Pharmacist interventions were retrieved from the hospital’s electronic health record system. Cost saving and cost avoidance analyses were carried out for antimicrobials-related interventions. Economic analysis was performed and tabulated both in PKR and USD.

RESULTS: Out of 2311 interventions, 2136 (92.4%) interventions were accepted and 175 (7.5%) were either rejected or had no decision by primary physician. Interventions related to bug-drug mismatch system alert (386, 16.7%), renal dose adjustments (806, 34.87%), unnecessary dual coverage (158, 6.8%), adverse drug reaction of antimicrobials through integrated lab alerts (290, 12.54%), IV to PO switch (496, 21.46%), and duration of therapy (175, 7.5%). Review of antibiotics is recorded as 100% as all antibiotics orders appeared in clinical pharmacist’s daily queue for review and acceptance rate is recorded as 92.4% by primary physician. Overall, cost analysis showed that pharmacist interventions through electronic health record system saved around 150,110.23 US dollars.

CONCLUSIONS: Antimicrobial stewardship services provided by clinical pharmacist through integrated electronic health record system are a cost saving program. The cost saved per intervention for our study is around USD 65.