A Drug Utilization Evaluation Study of Intravenous Acetaminophen in a Large Teaching Hospital in Iran

Background: IV acetaminophen has become the most commonly chosen analgesic medication in critical care settings. Overall, the cost of the drug is higher than oral and rectal acetaminophen. As a result, numerous studies have been performed to evaluate the appropriatenessof IV acetaminophen use based on guidelines. A lot of studies have shown that there is poor quality in compliance with guideline in developing countries. Current study aims to evaluate prescribing behavior of IV acetaminophen regimens in hospitalized adults in Tehran, Iran. Material andmethods: We enrolled 277 patients (including 137 men and 140 women) with age ranged between 18-65 years in Ziaeian hospital, Tehran, Iran. Demographic data and clinical and preclinical parameters such as blood urea nitrogen (BUN) and creatinine levels, name of ward, prescribingreason, doses, dose intervals, number of doses, type of vehicle used and durations of infusion were collected and recorded for analysis. Results: Our results have shown that guideline concordance was seen only in 20 (7.22%) out of 277 patients. IV acetaminophen is prescribed mostly byemergency medicine specialists, and it is more inappropriately prescribed by these specialists in comparison to other specialists. It was also found that non-compliance of IV acetaminophen prescribing with guideline imposes 1038 USD additional expenditure on health care system of thehospital. Indirect costs resulting from preventable adverse events, physician and nurse manpower and time was not calculated. Conclusion: The evaluation of prescribing indicators showed low quality prescription by medical specialists. The pattern of prescribing depending on the medicalspecialties was also different. In addition, overuse and misuse of IV acetaminophen imposes substantial cost and the economic burden on healthcare system.

کلیدواژه ها:

Intravenous (IV) ، acetaminophen Drug utilization research ، Appropriate drug use ،