Electronic alert cuts proportion of IV proton pump inhibitors

(HealthDay)—An electronic alert triggered on order of intravenous (IV) proton pump inhibitors (PPI) can decrease the proportion of IV PPIs ordered, according to a research letter published online Jan. 19 in JAMA Internal Medicine.

Daniel E. Freedberg, M.D., from the Columbia University Medical Center in New York City, and colleagues examined the response of health care professionals to an alert that was triggered by all IV PPI orders. The alert explained that the cost of oral PPIs is one-tenth of that of IV PPIs and they are 90 percent bioavailable. The proportion of IV PPIs was compared one year after versus one year before implementation of the alert.

During the study period, there were 65,078 completed orders for PPIs. The researchers found that 30.0 percent of orders before the alert were IV PPIs, compared with 23.0 percent after implementation of the alert (P < 0.001), representing a 23.4 percent relative reduction in the proportion of IV PPIs. After implementation of the alert, the proportion of IV PPI orders completed remained significantly decreased, even after adjustment for the trend in IV PPI use before the alert (P < 0.001). The estimated annual decrease in institutional costs related to IV PPI use was $450,692 during the year after the alert.

"Our study highlights the potential for electronic alerts to alter ordering behavior for IV PPIs," the authors write.