Table 3.
Results – Prescriptions for which Prescribers were Adherent to Drug-Laboratory Monitoring Guidelines
| Pre-implementation | Transition | Post-implementation | p-value* | |
|---|---|---|---|---|
| Prescriptions with ALT monitoring | 6,940 | 13,990 | 7,311 | |
| • Labs required, but not drawn | 3,343 (48%) | 5,693 (41%) | 2,531 (36%) | |
| • Labs required and drawn (any time) | 3,597 (52%) | 8,297 (59%) | 4,780 (65%) | <0.001 |
| • Labs drawn, not within time guideline | 2,611 (38%) | 6,267 (45%) | 3,243 (44%) | |
| – Within normal limits | 2,493 (96%) | 6,150 (98%) | 3,174 (98%) | |
| • Met time guidelines | 986 (14%) | 2,030 (15%) | 1,537 (21%) | <0.001 |
| – Within normal limits | 978 (99%) | 2,000 (99%) | 1,527 (99%) | |
| Prescriptions with AST monitoring | 6,940 | 13,990 | 7,311 | |
| • Labs required, but not drawn | 3,333 (48%) | 5,715 (41%) | 2,540 (35%) | |
| • Labs required and drawn (any time) | 3,607 (52%) | 8,275 (59%) | 4,771 (65%) | <0.001 |
| • Labs drawn, not within time guideline | 2,615 (38%) | 6,248 (45%) | 3,216 (44%) | |
| – Within normal limits | 2,496 (95%) | 6,128 (98%) | 3,144 (98%) | |
| • Met time guidelines | 992 (14%) | 2,027 (15%) | 1,555 (21%) | <0.001 |
| – Within normal limits | 987 (100%) | 2,010 (99%) | 1,546 (99%) | |
| Prescriptions with SCr monitoring | 3,234 | 6,398 | 3,406 | |
| • Labs required, but not drawn | 1,563 (48%) | 2,676 (42%) | 1,227 (36%) | |
| • Labs required and drawn (any time) | 1,671 (52%) | 3,722 (58%) | 2,179 (64%) | <0.001 |
| • Labs drawn, not within time guideline | 1,172 (36%) | 2,722 (43%) | 1,482 (44%) | |
| – Within normal limits | 1,064 (91%) | 2,569 (94%) | 1,383 (93%) | |
| • Met time guidelines | 499 (15%) | 1,000 (16%) | 697 (21%) | <0.001 |
| – Within normal limits | 452 (91%) | 931 (93%) | 651 (93%) | |
| Prescriptions with CK monitoring | 2,283 | 4,940 | 2,604 | |
| • Labs required, but not drawn | 2,116 (93%) | 4,660 (94%) | 2,453 (94%) | |
| • Labs required and drawn (any time) | 167 (7%) | 280 (6%) | 151 (6%) | 0.032 |
| • Labs drawn, not within time guideline | 2 (0.1%) | 14 (0.3%) | 13 (0.5%) | |
| – Within normal limits | 2 (100%) | 13 (93%) | 12 (92%) | |
| • Met time guidelines | 165 (7%) | 266 (5%) | 138 (5%) | 0.005 |
| – Within normal limits | 161 (98%) | 263 (99%) | 136 (99%) | |
| Prescriptions with LDL monitoring | 3,408 | 7,007 | 3,613 | |
| • Labs required, but not drawn | 1,510 (44%) | 2,701 (39%) | 1,317 (37%) | |
| • Labs required and drawn (any time) | 1,898 (56%) | 4,306 (62%) | 2,296 (64%) | <0.001 |
| • Labs drawn, not within time guideline | 1,536 (45%) | 3,537 (51%) | 1,701 (47%) | |
| – Mean (SD) LDL level (mg/dL; mmol/L) | 97 (33); 2.5 (0.9) | 98 (33); 2.5 (0.9) | 99 (34); 2.6 (0.9) | |
| • Met time guidelines | 362 (10.6%) | 769 (11%) | 595 (17%) | <0.001 |
| – Mean (SD) LDL level (mg/dL; mmol/L) | 103 (34); 2.7 (0.9) | 100.4 (35);2.59 (0.9) | 99 (33); 2.6 (0.9) | |
| Prescriptions with HbA1c monitoring | 6,639 | 13,192 | 6,976 | |
| • Labs required, but not drawn | 1,798 (27%) | 3,691 (28%) | 1,998 (29%) | |
| • Labs required and drawn (any time) | 4,841 (73%) | 9,501 (72%) | 4,978 (71%) | 0.43 |
| Prescriptions with ALT monitoring | 6,940 | 13,990 | 7,311 | |
| • Labs drawn, not within time guideline | 1,842 (28%) | 5,156 (39%) | 2,155 (31%) | |
| – Mean (SD) HbA1c level (%; proportion total Hb) | 7.9 (1.6); 0.08 (0.02) | 7.8 (1.5); 0.08 (0.02) | 7.7 (1.5); 0.08 (0.02) | |
| • Met time guidelines | 2,999 (45%) | 4,345 (33%) | 2,823 (41%) | <0.001 |
| – Mean (SD) Hb1c level (%; proportion total Hb) | 7.7 (1.4); 0.08 (0.01) | 7.7 (1.3); 0.08 (0.01) | 7.6 (1.3); 0.08 (0.01) |
Within normal limits: <3 times upper limit of normal for AST/ALT/CK; SCr <1.5 (males), <1.4 (females); Hb = hemoglobin;
*p-values compare pre-to post-implementation