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

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.