Clinica chimica acta; international journal of clinical chemistry · 2020
Less is more: Two automated interventions to increase vitamin B12 measurement when long-term proton pump inhibitor and decrease redundant testing.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Salinas Maria, López-Garrigós Maite, Flores Emilio, Blasco Alvaro, Leiva-Salinas Carlos, PRIMary Care-LABoratory (PRIMLAB) working group
Аннотация
INTRODUCTION: To test the efficacy of two interventions to promote the measurement of serum vitamin B12 (s- vitamin B12) in patients with long-term proton pump inhibitor (PPI) use and to decrease inadequate s-vitamin B12 measurement by implementing a minimum retest interval.
MATERIAL AND METHODS: The Laboratory Information System (LIS) automatically registered s-vitamin B12 when not ordered by General Practitioners to all requests patients with long term (>3years) PPI treatment, and with no s-vitamin B12 testing in the previous year. Through the second intervention, the LIS reported the previous s-vitamin B12 result through an explanatory comment in the report, when the test had been requested in the previous three months. We calculated the new diagnoses of vitamin deficiency (s-vitamin B12 < 200 pg/mL), examined the number of tests needed to detect a new case and investigated the economic cost of each one identified by the intervention. Additionally, we counted the s-vitamin B12 that were requested but not measured, and calculated the savings in reagent.
RESULTS: The strategy added 548 s-vitamin B12 and identified 47 new cases of vitamin B12 deficit. The number of added s-vitamin B12 needed to identify a new case by means of the intervention was 12. The total intervention reagent cost was 1446€, with a cost of 30.7€ per new case. The second intervention avoided unnecessary measurement of 611 tests, with 1613€ savings.
CONCLUSIONS: Through the two automated interventions we improved the diagnosis of vitamin B12 deficiency, and decreased inadequate redundant s-vitamin B12 measurement, cutting unnecessary laboratory costs.
MATERIAL AND METHODS: The Laboratory Information System (LIS) automatically registered s-vitamin B12 when not ordered by General Practitioners to all requests patients with long term (>3years) PPI treatment, and with no s-vitamin B12 testing in the previous year. Through the second intervention, the LIS reported the previous s-vitamin B12 result through an explanatory comment in the report, when the test had been requested in the previous three months. We calculated the new diagnoses of vitamin deficiency (s-vitamin B12 < 200 pg/mL), examined the number of tests needed to detect a new case and investigated the economic cost of each one identified by the intervention. Additionally, we counted the s-vitamin B12 that were requested but not measured, and calculated the savings in reagent.
RESULTS: The strategy added 548 s-vitamin B12 and identified 47 new cases of vitamin B12 deficit. The number of added s-vitamin B12 needed to identify a new case by means of the intervention was 12. The total intervention reagent cost was 1446€, with a cost of 30.7€ per new case. The second intervention avoided unnecessary measurement of 611 tests, with 1613€ savings.
CONCLUSIONS: Through the two automated interventions we improved the diagnosis of vitamin B12 deficiency, and decreased inadequate redundant s-vitamin B12 measurement, cutting unnecessary laboratory costs.