Utilization patterns of total parenteral nutrition in a university hospital

Abstract

To study the utilization of total parenteral nutrition, using methodology recommended by the World Health Organization, classification of components in accordance with the anatomical therapeutic chemical classification and defined daily dose system is necessary. Anatomical therapeutic chemical indices are available but defined daily dose values have not been established yet. In this article, a methodology to study both the total utilization of total parenteral nutrition, the utilization of individual substances and the composition of total parenteral nutrition is presented. To validate the proposed methodology, the utilization of total parenteral nutrition in a teaching hospital is studied, based on pharmacy computer data. The total utilization of total parenteral nutrition in the hospital in 1990 is 1.4 defined daily doses/100 bed-days. The composition of total parenteral nutrition varied greatly between the clusters. In this study we showed that utilization of total parenteral nutrition can be measured with the proposed methodology, using a defined daily dose for total parenteral nutrition in concurrence with a defined daily dose for the individual components.

Analysis of total parenteral nutrition utilization in intensive-care patients

“…The utilization is more than twice as high as the 9.6 DDD/100 beddays for the intensive-care cluster found in our preliminary study [9]. This difference can be explained by the limitation of the present study to ICU's where TPN is mostly used, as coronary care, cardiosurgical, and neurological units were excluded.…”

“…It was postulated that the all-in-one DDD methodology allows calculation of the total number of DDD's TPN that is used [9]. This postulation was validated by calculating the ratio of the total number of DDD's used and the number of days that TPN was used (user days).…”

“…Furthermore, preliminary retrospective data were presented [9]. The main purpose of the present study is to validate the proposed methodology with prospective patient-linked data.…”