Inpatient Neurology Consultation Service in a tertiary care teaching hospital in Jordan: Effectiveness, Drug Utilization Pattern, and Cost

Amro B Lahlouh, Roa'a W Jaradat, Suha A Aqaileh

Abstract


In-hospital consultation (IHC) is a fundamental process at clinical institutions especially within tertiary
care centers. We conducted a 3-months-prospective study to evaluate the neurology consultation service
in terms of reasons for consult, outcomes retrieved, medication utilization pattern, and cost at a large
teaching hospital in Jordan. A total of 199 patients had received in-patient neurology consultations (3
consultation/working day). Departments of internal medicine (47.7%) and neurosurgery (13.1%) made
the majority of referrals. Common complaints which dictated consultations were: Preoperative
evaluation of an already established neurological disease, focal weakness/ numbness, and decreased
level of consciousness (16.6, 15.1, and 13.6). The largest proportion of outcomes retrieved from
neurology consultation service was establishing new diagnosis for a neurologic disease (44.2 [29.6%
acute and 14.6% chronic]). Regarding medication utilization pattern, additional medications were
prescribed in 32.2% of patients while increasing dose was attempted in 8.5%. Levetiracetam was the
most frequent medication to be added and also the most common medication which dose was increased.
Time consumed per initial visit was at a median of 10 mins/patient (IQR: 8-15). Neurology consultation
service yielded a significant contribution to diagnostic and management plan for patients. However, the
process is costly and somehow time consuming.

Keywords


Neurology; consultations; cost; medication utilization pattern.

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