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358
teaching program during a single residency year were invited
to participate in the study. This totaled 304 pharmacists and
34 pharmacy residents.

Survey Design and Distribution
The survey was developed in QuestionPro, an online survey
tool. Pharmacists and pharmacy residents were asked to
enter a value to estimate the cost of 15 laboratory tests to the
nearest dollar. The prices of these tests were ascertained from
a local health institution based on Medicare and Medicaid
reimbursement rates. In addition, participants were asked to
rate their level of agreement with 3 statements focused on
how knowledge of laboratory costs would impact their current drug monitoring practices using a 10-point Likert scale.
Demographics regarding the participants were obtained.
The survey link was distributed by the principal investigator via a secure-encryption e-mail to a contact person at each
of the participating hospital sites. The contact person distributed the survey link to all eligible participants. A reminder
e-mail was sent 2 weeks following the initial e-mail, and the
survey closed 4 weeks after the first e-mail was sent. Pharmacy
residents were asked to complete the same online survey to
assess their baseline knowledge, which was then closed after
4 weeks. All survey responses were anonymous.
A brief lecture detailing the costs of individual laboratory
tests, in the form of patient cases, was presented to the pharmacy residents after the close of the initial survey. The lecture was limited to the pharmacy residents due to logistics.
One month after completion of the education session, a follow-up survey link was distributed via e-mail to determine
the effectiveness of the lecture. A reminder e-mail was sent 2
weeks following the first e-mail. The follow-up survey was
available for 4 weeks.
This study was approved by the institutional review
board.

Statistics
Survey data were automatically collected via the Web-based
survey program and were downloaded directly into IBM
SPSS (version 22.0; IBM, Inc, Armonk, New York) for statistical analysis. Estimates of cost were categorized into 4
groups based on margin of error from the actual cost of the
laboratory test. The 4 margin of error groups were as follows: 0% to 10%, 10.01% to 20%, 20.01% to 30%, and
greater than 30%. A Mann-Whitney U test was used to compare pharmacy resident responses before and after the lecture
intervention to assess improvement from baseline.

Results
A total of 81 out of 338 pharmacists and pharmacy residents
responded to the initial survey, representing an overall
response rate of 24%. Five of the surveys were not complete;

Hospital Pharmacy 52(5)
Table 1. Demographics of Survey Respondents.
Demographics
Position
Pharmacy resident
Staff pharmacist
Clinical pharmacist
Years in practice
Less than 1 y
1-5 y
6-10 y
10-15 y
More than 15 years
Years able to independently
order labs
Less than 1 y
1-5 y
6-10 y
10-15 y
More than 15 years

Survey respondents, n (%)
19 (24.7)
23 (29.9)
35 (45.4)
18 (22.7)
26 (32.9)
9 (11.3)
8 (10.1)
18 (22.7)

21 (26.9)
27 (34.6)
9 (11.54)
9 (11.54)
12 (15.38)

however, all responses were used when provided. The demographics are shown in Table 1.
Overall, the cost estimates ranged from $1 to $500. The
highest correct responses were for gentamicin and tobramycin serum concentrations (17.1% and 18.4%, respectively, of
estimates within 10% of the correct answer). Greater than
64% of all responses were outside the 30% margin of error
from the actual cost for all 15 laboratory tests. The laboratory
cost that represented the highest number of estimates greater
than 30% away from the actual cost was for serum creatinine. The detailed results are provided in Table 2.
When evaluating the results of the statements presented in
the survey, it was found that the majority of pharmacists
reported that they did not have sufficient knowledge of the
cost of laboratory tests. Pharmacists were neutral (with 5
being the most frequent response on the Likert scale) regarding whether or not the cost of the laboratory values influenced their drug monitoring or whether or not better
knowledge of costs would change how they monitor drug
therapy.

Posteducation Session Follow-Up
A total of 19 pharmacy residents responded to the initial survey and 10 residents responded to the follow-up survey. Two
surveys were not completed; however, all responses were
used where provided. There were no significant differences
in cost estimation from baseline. When the data were analyzed in the groups with respect to error ranges, it was found
that ALT/AST and lipid panel tests had P values of .008 and
.014, respectively, showing improvement in cost knowledge.
The residents estimated the costs of ALT/AST and vancomycin within 10% of the actual cost 40% of the time. The test
that elicited the most divergent approximations from actual



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
Hospital Pharmacy - May 2017 - 381
Hospital Pharmacy - May 2017 - 382
Hospital Pharmacy - May 2017 - 383
Hospital Pharmacy - May 2017 - 384
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