Evidence map›Paper›PMID 31433770›Full record

ArticleJournal of hospital medicine2020

Leveraging the Outpatient Pharmacy to Reduce Medication Waste in Pediatric Asthma Hospitalizations.

Erik R Hoefgen, Yemisi Jones, Joshua Courter, Andrew Hare, José A Torres Garcia, Jeffrey Simmons

Open access · bronzeAbstract read
In one paragraph

Article in Journal of hospital medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 89% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Environmental sustainability in asthma: reducing carbon footprint and medication wastage.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Erik R HoefgenWashington University School of Medicine, Department of Pediatrics, St. Louis, Missouri. Formerly Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Yemisi JonesCincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Joshua CourterDivision of Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Andrew HareDivision of Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
José A Torres GarciaUniversity of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado. Formerly Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Jeffrey SimmonsCincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Cincinnati Children's Hospital Medical Center · USUniversity of Colorado Anschutz Medical Campus · USWashington University in St. Louis · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivePrevious local quality improvement focused on discharging patients with inhaled corticosteroids (ICS) "in-hand" decreased healthcare reutilization after hospitalization for an asthma exacerbation. However, as a result of these new processes, some patients admitted for an asthma exacerbation received more than one ICS inhaler during their admission, contributing to medication waste and potential patient confusion regarding their discharge medication regimen. We sought to decrease this waste.

methodsWe conducted a quality improvement project to reduce the prescribing of multiple ICS inhalers to patients at a large academic children's hospital. Our primary outcome measure was the monthly percentage of patients admitted with an asthma exacerbation who were administered more than one ICS inhaler. A secondary outcome measure evaluated the reliability of the new process of using the hospital-based outpatient pharmacy to supply ICS "in-hand" and verify insurance coverage. After the process map review, we hypothesized a delay in the initial ICS treatment decision would allow for both a finalized discharge medication plan and a standardized process to verify outpatient insurance coverage.

resultsThe mean percentage of patients receiving more than one ICS inhaler decreased from our baseline of 7.4% to 0.7%. Verification of outpatient prescription insurance coverage via the outpatient pharmacy increased from 0.7% to 50%. The average inpatient cost (average wholesale price) for ICS decreased by 62% to $90.25.

conclusionsOur process change to use the outpatient pharmacy to dispense and verify insurance coverage for ICS medication was associated with a reduction in medication waste during admission for an asthma exacerbation.

Indexed as

HospitalizationInpatientsPharmacyAdministration, InhalationAdrenal Cortex HormonesAsthmaChildHospitals, PediatricHumansInsurance CoverageAdrenal Cortex Hormones

Identifiers

PMID31433770
PMCPMC6932591
OpenAlexW2969941946

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.