Background: Based on the UK National Minimum Retesting Interval Project Recommendations, we verified whether POP-UP allows appropriate VitD retesting (minimum = 90 days). Materials and methods: POP-UP was applied for one year to inpatients. One year VitD free (FREE-YEAR) and one year POP-UP (POPUP-YEAR) VitD requests were collected (LIS), comparing outpatients and inpatients. These were further classified as coming from medical, surgical, or maternal and child area. The number of patients with repeated VitD was identified for each area. Results: VitD was requested once/year in 11.6% and in 13.1% and at least twice in 3.7% and 4.1% inpatients in FREE-YEAR and POPUP-YEAR respectively. Considering both in- and out-patients, VitD assay was offered to 35564 and 38217 patients in FREE-YEAR and POPUP-YEAR, being repeated at least twice in 15% and 13% (X2 = 42, p < 0.0001). This reduction was confirmed among outpatients (from 11.3% to 9.4%), not among inpatients (24% unchanged). The time interval between repeated testing was shorter in POPUP-YEAR (128±1 days) than in FREE-YEAR (179±2 days, mean±SE) (t = 25.5, p < 0.0001). Time interval between two repeated VitD measures was dependent on POP-UP (p < 0.0001), medical area (p < 0.0001), gender (p = 0.02) and on VitD result (p = 0.0005), not on age (p = 0.308) (multivariate ANOVA). VitD retesting was classified as appropriate ( < = 90 days) or non-appropriate ( > 90 days). A significant decrease in inappropriate retesting was observed in POPUP-YEAR for inpatients belonging to medical (p < 0.0001) or surgical (p = 0.003) areas, while it increased in the maternal and child area or remained unchanged among outpatients (p = 0.089). For 4 months POP-UP was replaced by an IT-block for inpatients or a clinical comment for outpatients, and this caused a fall in retesting to 2.5%. Conclusion: although POP-UP might determine a slight reduction in inappropriate VitD retesting, this approach does not render appropriateness a routine. Minimal retesting interval rejection rules appear a cheap and sustainable method toward more appropriate retesting.

AUTOMATED IT-BASED INTERVAL POP-UP (POP-UP) HAS LITTLE IMPACT ON VITAMIN D (VITD) APPROPRIATE MINIMUM RETESTING

PELLOSO, MICHELA;FOGAR, PAOLA;PADOAN, ANDREA;BASSO, DANIELA;PLEBANI, MARIO
2015

Abstract

Background: Based on the UK National Minimum Retesting Interval Project Recommendations, we verified whether POP-UP allows appropriate VitD retesting (minimum = 90 days). Materials and methods: POP-UP was applied for one year to inpatients. One year VitD free (FREE-YEAR) and one year POP-UP (POPUP-YEAR) VitD requests were collected (LIS), comparing outpatients and inpatients. These were further classified as coming from medical, surgical, or maternal and child area. The number of patients with repeated VitD was identified for each area. Results: VitD was requested once/year in 11.6% and in 13.1% and at least twice in 3.7% and 4.1% inpatients in FREE-YEAR and POPUP-YEAR respectively. Considering both in- and out-patients, VitD assay was offered to 35564 and 38217 patients in FREE-YEAR and POPUP-YEAR, being repeated at least twice in 15% and 13% (X2 = 42, p < 0.0001). This reduction was confirmed among outpatients (from 11.3% to 9.4%), not among inpatients (24% unchanged). The time interval between repeated testing was shorter in POPUP-YEAR (128±1 days) than in FREE-YEAR (179±2 days, mean±SE) (t = 25.5, p < 0.0001). Time interval between two repeated VitD measures was dependent on POP-UP (p < 0.0001), medical area (p < 0.0001), gender (p = 0.02) and on VitD result (p = 0.0005), not on age (p = 0.308) (multivariate ANOVA). VitD retesting was classified as appropriate ( < = 90 days) or non-appropriate ( > 90 days). A significant decrease in inappropriate retesting was observed in POPUP-YEAR for inpatients belonging to medical (p < 0.0001) or surgical (p = 0.003) areas, while it increased in the maternal and child area or remained unchanged among outpatients (p = 0.089). For 4 months POP-UP was replaced by an IT-block for inpatients or a clinical comment for outpatients, and this caused a fall in retesting to 2.5%. Conclusion: although POP-UP might determine a slight reduction in inappropriate VitD retesting, this approach does not render appropriateness a routine. Minimal retesting interval rejection rules appear a cheap and sustainable method toward more appropriate retesting.
2015
Clin Chem Lab Med
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/3157760
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