The impact of pharmacy mediated conversion from intravenous to oral corticosteroids in patients with an exacerbation of chronic obstructive pulmonary disease

Abstract

Purpose: The purpose of this study was to evaluate a pharmacist initiated conversion program from intravenous (IV) to oral corticosteroids in patients with chronic obstructive pulmonary disease (COPD) exacerbations. Methods:We conducted a retrospective observational study of patients who were admitted with a diagnosis of COPD exacerbation. The historical control group, included patients admitted between October 1 and December 31, 2013, did not have any intervention from pharmacists regarding conversion. The post intervention group, included patients admitted between October 1 and December 31, 2014, exposed to the new conversion program. Electronic medical records were reviewed for: time needed for conversion, hospital length of stay, and readmission rate for both groups.Results: There were a total of 122 patients in the study. A low number of patients in the post intervention group (n = 11, 22%) received pharmacist intervention. No significant difference was observed in hospital length of stay, time to conversion, or 30-day readmission rates. More patients in the intervention group received methylprednisolone as initial IV therapy (P = 0.002). Conclusions:Among patients with COPD exacerbations, the automatic pharmacist medicated conversion program did not affect time to conversion, hospital length of stay, or readmission rates.