Abstract:The purpose of this study was to determine the feasibility of a protocol-driven approach to optimize the absorption of drugs physically incompatible with enteral nutrition in critical care patients on continuous tube feeds during 6 quarterly review periods. A hospital-based interdisciplinary protocol was approved in which physically incompatible drugs could be converted from the IV (intravenous) or oral formulation to an enteral formulation and administered during a "no tube-feed" interval. Eligible patients included those receiving continuous TF (tube feed formulas) and enterally administered medications for at least 2 days while receiving a physically incompatible target drug from the protocol. The primary outcome was the percentage of physically incompatible target drugs successfully converted to the appropriate enteral formulation and administration time. The secondary outcomes were the cost savings of all enteral target drugs converted during each quarter based on a 7 day review and the total cost savings of each target drug converted during the entire study. The primary outcome of successful drug conversions to the appropriate enteral administration was 100% for 5 of the 6 quarters and 81 percent for one quarter. The secondary outcome of cost savings of all enteral drug conversions averaged $975 per quarter. Also, the cost savings of each of the enteral target drug conversions for the entire study was between $3,376 for the most costly drug and $26 for least costly drug. The study shows that an interdisciplinary protocol with "no tube-feed" intervals is a feasible and cost effective method to successfully optimize the absorption of physically incompatible drugs with enteral formulas during continuous tube feedings.