Emergency Department Drug Orders: Does Drug Storage Location Make a Difference?

Abstract

We hypothesize that adding drugs previously only available from the hospital central pharmacy to an existing emergency department (ED) automated medication management system would alter the frequency with which they were ordered. A pharmacy database of a large, urban, academic teaching hospital was used to retrospectively calculate changes in drug-ordering frequencies before and after study drugs were added to an ED automated medication management system. Study drugs had been recently added to our ED automated medication management system but were still available from the hospital central pharmacy and were not the subject of changes in hospital prescribing protocols. Four drug preparations met study criteria: moxifloxacin injection, moxifloxacin tablets, azithromycin injection, and pantoprazole injection. All had large increases (4.0-, 7.2-, 6.5-, and 25.0-fold, respectively) in ordering frequency after addition to the ED automated medication management system. Changes in order frequency strongly correlated with how often orders were filled from the ED automated medication management system rather than the hospital central pharmacy. Adding drug preparations to an existing ED automated medication management system increased the frequency with which they were ordered, especially when they were most reliably obtained from the system rather than the central hospital pharmacy. Adding drugs to an ED automated medication management system influences physician drug ordering.