Clinical guidelines and pharmacist intervention program for HIV-infected patients requiring granulocyte colony-stimulating factor therapy

Guidelines, implemented by clinical pharmacists, were developed by the phar macy and therapeutics subcommittee on a dedicated service caring for hospit alized patients with human immunodeficiency virus infection or the acquired immunodeficiency syndrome (AIDS) who required granulocyte colony-stimulati ng factor (G-CSF) therapy. Drug use and evaluation was conducted on all pat ients with AIDS who were prescribed G-CSF, and education was provided to me dical house staff. Clinical data from chart review and laboratory and billi ng data bases of the hospital medical information system were compared for the 9-month intervention period (IP) with data from the 9-month preinterven tion period (PIP). Comparing the IP and PIP, the mean number of G-CSF doses (0.29 vs 0.51) and pharmacy costs per day ($112 vs $200) decreased, with n o change in the number of patients requiring G-CSF. The 1.3 pharmacist inte rventions per patient resulted in a decrease to 2.4 doses per admission fro m a baseline of 5.9 (p<0.0001). Mean hospital stay (11.9 vs 13.8 days) and mean number of days of neutropenia did not differ for IP and PIP groups. Ef fectively implemented pharmacist-based interventions can decrease hospital costs without increasing patient morbidity.