Analysis to determine cost-effectiveness of procalcitonin-guided antibiotic use in adult patients with suspected bacterial infection and sepsis.
Purpose Results of a study incorporating real-world results into a predictive model to assess the cost-effectiveness of procalcitonin (PCT)-guided antibiotic use in intensive care unit patients with sepsis are reported. Methods A single-center, retrospective cross-sectional study was conducted to de...
| Published in: | American Journal of Health-System Pharmacy Vol. 76; no. 16; pp. 1219 - 1226 |
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| Main Authors: | , , , , |
| Format: | algorithm research tables/charts Journal Article |
| Published: |
Oxford University Press / USA
Aug2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=137893502&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 137893502 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10792082 1X3 jtl: American Journal of Health-System Pharmacy issn: 10792082 maglogo: N pubinfo: dt: Aug2019 vid: 76 iid: 16 pid: 622 pub: Oxford University Press / USA artinfo: ui: 137893502 137893502 137893502 10.1093/ajhp/zxz129 137893502 ppf: 1219 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Analysis to determine cost-effectiveness of procalcitonin-guided antibiotic use in adult patients with suspected bacterial infection and sepsis. aug: au: Collins, Curtis D Brockhaus, Kara Sim, Taeyong Suneja, Anupam Malani, Anurag N affil: Department of Pharmacy Services, St. Joseph Mercy Health System, Ann Arbor, MI sug: subj: Cost Benefit Analysis Health Care Costs Evaluation Calcitonin Economics Antibiotics Economics Calcitonin Therapeutic Use Antibiotics Therapeutic Use Bacterial Infections Drug Therapy Bacteremia Drug Therapy Critically Ill Patients In Old Age Algorithms Human Aged Retrospective Design Cross Sectional Studies Treatment Duration Calcitonin Analysis Antibiotics Analysis Patient Admission Decision Making, Clinical Prospective Studies Cost Savings Models, Theoretical Quality-Adjusted Life Years Sex Factors Age Factors Scales Vasoconstrictor Agents Therapeutic Use Respiration, Artificial Quality of Life Aged: 65+ years ab: Purpose Results of a study incorporating real-world results into a predictive model to assess the cost-effectiveness of procalcitonin (PCT)-guided antibiotic use in intensive care unit patients with sepsis are reported. Methods A single-center, retrospective cross-sectional study was conducted to determine whether reductions in antibiotic therapy duration and other care improvements resulting from PCT testing and use of an associated treatment pathway offset the costs of PCT testing. Selected base-case cost outcomes in adults with sepsis admitted to a medical intensive care unit (MICU) were assessed in preintervention and postintervention cohorts using a decision analytic model. Cost-minimization and cost–utility analyses were performed from the hospital perspective with a 1-year time horizon. Secondary and univariate sensitivity analyses tested a variety of clinically relevant scenarios and the robustness of the model. Results Base-case modeling predicted that use of a PCT-guided treatment algorithm would results in hospital cost savings of $45 per patient and result in a gain of 0.0001 quality-adjusted life-year. After exclusion of patients in the postintervention cohort for PCT test ordering outside of institutional guidelines, the mean inpatient antibiotic therapy duration was significantly reduced in the postintervention group relative to the preintervention group (6.2 days versus 4.9 days, p = 0.04) after adjustment for patient sex and age, Charlson Comorbidity Index score, study period, vasopressor use, and ventilator use. Total annual hospital cost savings of $4,840 were predicted. Conclusion Real-world implementation of PCT-guided antibiotic use may have improved patients' quality of life while decreasing hospital costs in MICU patients with undifferentiated sepsis. pubtype: Academic Journal doctype: algorithm research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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