Hospital Pharmacy - May 2017 - 357

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HPXXXX10.1177/0018578717715357Hospital PharmacyVanGalder et al.

Article
Hospital Pharmacy
2017, Vol. 52(5) 357-360
© The Author(s) 2017
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https://doi.org/10.1177/0018578717715357
DOI: 10.1177/0018578717715357
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Pharmacists' Knowledge of the
Cost of Laboratory Testing
Keni VanGalder1, Tracey L. Mersfelder1, and Kali VanLangen1

Abstract
Purpose: The objective of this study was to ascertain baseline knowledge of pharmacists and pharmacy residents concerning
the cost of laboratory tests for monitoring medications, and to determine whether an educational session delivered to
pharmacy residents improves their knowledge of these costs. Methods: An online survey was provided to pharmacists
and pharmacy residents, testing their knowledge of 15 common laboratory tests used to monitor the safety and efficacy of
medications. One of the researchers presented a lecture to all pharmacy residents that detailed individual laboratory costs;
after that, the researchers delivered a follow-up survey to assess the effectiveness of the educational session. Results:
Baseline knowledge of pharmacists showed that greater than 64% of the responses were more than 30% away from the actual
cost of the laboratory test for all 15 tests. Baseline knowledge of pharmacy residents showed that greater than 58% of the
responses were more than 30% away from the actual cost of the laboratory test for each individual test. Although there was
no statistically significant improvement in individual cost prediction after the educational session, 2 laboratory values showed
improvement in margins of error post intervention: alanine aminotransferase/aspartate aminotransferase and lipids (P = .008
and .014, respectively). Conclusions: Pharmacists and pharmacy residents poorly predicted the costs of common laboratory
tests. A brief lecture discussing the cost of laboratory tests demonstrated minor improvement in pharmacy residents'
knowledge of the costs reviewed. Pharmacists need to be educated on the cost of laboratory tests to better understand the
profession's contribution to health care expenditures.
Keywords
health care costs, laboratory, pharmacist
There has been a persistent rise in the cost of health care in
the United States. Hospital expenditures rose from $933.5
billion to $971.8 billion (an increase of 4.1%) in 2014.1 A
component of the growth in expenditures is the laboratory
testing ordered. The cost of any single laboratory test is not
staggering; but because of the volume of laboratory testing
ordered for each patient every day, the total impact can be
substantial, especially when serial levels are followed over a
period of time. In 2008, the cost of medical diagnosis, including the laboratory testing, accounted for $250 billion in the
United States, which is roughly 10% of all medical costs.2
Several studies have shown that physicians, medical residents, and medical students are unaware of the economic
impact they have when ordering frequent laboratory tests.3-10
Starting as early as 1976 and as recently as 2014, studies
have repeatedly demonstrated that health care personnel lack
knowledge regarding the costs of laboratory tests.
The health professional overlooked in all of these studies
is the pharmacist. Pharmacists may be contributing to the
rise in costs, and they may be unaware of their role in the
mounting expenses related to drug monitoring. The pharmacists' scope of practice is expanding under protocols and collaborative practice agreements regarding their ability to

order laboratory tests for monitoring the efficacy and toxicity
of medications. It is not known whether pharmacists are
aware of the costs associated with monitoring drug therapy.
The objective of this study was to determine baseline knowledge of pharmacists and pharmacy residents in regard to the
costs associated with having laboratory tests performed. In
addition, this study endeavored to determine whether an education session delivered to pharmacy residents improved
their baseline knowledge of these costs.

Methods
Study Population
All pharmacists who perform pharmacokinetic services at 9
participating hospitals in a limited region of a Midwest state
and all pharmacy residents in this same region enrolled in a
1

Ferris State University, Grand Rapids, MI, USA

Corresponding Author:
Tracey L. Mersfelder, College of Pharmacy, Ferris State University, 25
Michigan Street NE, Grand Rapids, MI 49503, USA.
Email: TraceyMersfelder@ferris.edu


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Table of Contents for the Digital Edition of Hospital Pharmacy - May 2017

Editorial, For Sale: FDA Priority Review Vouchers
Current FDA-Related Drug Information; Approvals, Submission, and Important Labeling Changes for US Marketed Pharmaceuticals
Summaries of Safety Labeling Changes Approved by the FDA: Boxed Warnings
ISMP Adverse Drug Reactions: Levofloxacin-Induced Neuroexcitation and Hallucinations Statin-Induced Muscle Rupture Mefloquine-Induced Rhabdomyolysis Methimazole-Induced
Critical Care Pharmacist Market Perceptions: Comparison of Critical Care Program Directors and Directors of Pharmacy
Capecitabine, Oxaliplatin, and Bevacizumab (BCapOx) Regimen for Metastatic Colorectal Cancer
Clinical Pharmacy Discharge Counseling Service and the Impact on Readmission Rates in High-Risk Patients
Mannitol Prescribing Practices With Cisplatin Before and After an Educational Newsletter Intervention
Pharmacists’ Knowledge of the Cost of Laboratory Testing
Adverse Drug Reaction Reporting Practices Among United Arab Emirates Pharmacists and Prescribers
Postoperative Pain Management With Liposomal Bupivacaine in Patients Undergoing Orthopedic Knee and Hip Arthroplasty at a Community Hospital
Formulary Drug Reviews
Hospital Pharmacy - May 2017 - 317
Hospital Pharmacy - May 2017 - 318
Hospital Pharmacy - May 2017 - 319
Hospital Pharmacy - May 2017 - 320
Hospital Pharmacy - May 2017 - 321
Hospital Pharmacy - May 2017 - 322
Hospital Pharmacy - May 2017 - 323
Hospital Pharmacy - May 2017 - Editorial, For Sale: FDA Priority Review Vouchers
Hospital Pharmacy - May 2017 - 325
Hospital Pharmacy - May 2017 - Current FDA-Related Drug Information; Approvals, Submission, and Important Labeling Changes for US Marketed Pharmaceuticals
Hospital Pharmacy - May 2017 - Summaries of Safety Labeling Changes Approved by the FDA: Boxed Warnings
Hospital Pharmacy - May 2017 - 328
Hospital Pharmacy - May 2017 - 329
Hospital Pharmacy - May 2017 - ISMP Adverse Drug Reactions: Levofloxacin-Induced Neuroexcitation and Hallucinations Statin-Induced Muscle Rupture Mefloquine-Induced Rhabdomyolysis Methimazole-Induced
Hospital Pharmacy - May 2017 - 331
Hospital Pharmacy - May 2017 - 332
Hospital Pharmacy - May 2017 - 333
Hospital Pharmacy - May 2017 - Critical Care Pharmacist Market Perceptions: Comparison of Critical Care Program Directors and Directors of Pharmacy
Hospital Pharmacy - May 2017 - 335
Hospital Pharmacy - May 2017 - 336
Hospital Pharmacy - May 2017 - 337
Hospital Pharmacy - May 2017 - 338
Hospital Pharmacy - May 2017 - 339
Hospital Pharmacy - May 2017 - 340
Hospital Pharmacy - May 2017 - Capecitabine, Oxaliplatin, and Bevacizumab (BCapOx) Regimen for Metastatic Colorectal Cancer
Hospital Pharmacy - May 2017 - 342
Hospital Pharmacy - May 2017 - 343
Hospital Pharmacy - May 2017 - 344
Hospital Pharmacy - May 2017 - 345
Hospital Pharmacy - May 2017 - 346
Hospital Pharmacy - May 2017 - 347
Hospital Pharmacy - May 2017 - Clinical Pharmacy Discharge Counseling Service and the Impact on Readmission Rates in High-Risk Patients
Hospital Pharmacy - May 2017 - 349
Hospital Pharmacy - May 2017 - 350
Hospital Pharmacy - May 2017 - 351
Hospital Pharmacy - May 2017 - 352
Hospital Pharmacy - May 2017 - Mannitol Prescribing Practices With Cisplatin Before and After an Educational Newsletter Intervention
Hospital Pharmacy - May 2017 - 354
Hospital Pharmacy - May 2017 - 355
Hospital Pharmacy - May 2017 - 356
Hospital Pharmacy - May 2017 - Pharmacists’ Knowledge of the Cost of Laboratory Testing
Hospital Pharmacy - May 2017 - 358
Hospital Pharmacy - May 2017 - 359
Hospital Pharmacy - May 2017 - 360
Hospital Pharmacy - May 2017 - Adverse Drug Reaction Reporting Practices Among United Arab Emirates Pharmacists and Prescribers
Hospital Pharmacy - May 2017 - 362
Hospital Pharmacy - May 2017 - 363
Hospital Pharmacy - May 2017 - 364
Hospital Pharmacy - May 2017 - 365
Hospital Pharmacy - May 2017 - 366
Hospital Pharmacy - May 2017 - Postoperative Pain Management With Liposomal Bupivacaine in Patients Undergoing Orthopedic Knee and Hip Arthroplasty at a Community Hospital
Hospital Pharmacy - May 2017 - 368
Hospital Pharmacy - May 2017 - 369
Hospital Pharmacy - May 2017 - 370
Hospital Pharmacy - May 2017 - 371
Hospital Pharmacy - May 2017 - 372
Hospital Pharmacy - May 2017 - 373
Hospital Pharmacy - May 2017 - Formulary Drug Reviews
Hospital Pharmacy - May 2017 - 375
Hospital Pharmacy - May 2017 - 376
Hospital Pharmacy - May 2017 - 377
Hospital Pharmacy - May 2017 - 378
Hospital Pharmacy - May 2017 - 379
Hospital Pharmacy - May 2017 - 380
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Hospital Pharmacy - May 2017 - 384
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