Date of Award

Fall 2014

Degree Type


Degree Name

Master of Science (MS)


Pharmacy Practice

First Advisor

Joseph Thomas

Committee Member 1

Mangala Subramaniam

Committee Member 2

Gail D. Newton


The objectives for this study were to 1) assess the current extent, scope and perceptions of CDTM in U.S. hospitals, 2) determine the associations between hospital characteristics, pharmacy director characteristics, and perceptions of CDTM, 3) investigate hospitals' short-term and long-term plans regarding CDTM, and 4) identify pharmacy directors' views about the major facilitators and barriers for CDTM in hospitals.

A self-administered written survey was mailed to a national random sample of hospitals stratified by state. Pharmacy directors indicated whether any pharmacists were engaged in CDTM, what CDTM activities were permitted, and in what treatment categories CDTM was permitted. Demographic data was also collected on both pharmacy director characteristics as well as hospital characteristics. All respondents were asked to indicate their views of CDTM in terms of support for CDTM, financial impact of CDTM, strategic impact of CDTM and effect of CDTM regulations on practice, on a 5-point Likert-type scale, where 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, and 5 = strongly agree. The respondents also indicated their plans for expanding CDTM in their hospitals on a 5-point Likert-type scale, where 1 = large decrease, 2 = slight decrease, 3 = no change, 4 = slight increase, and 5 = large increase. All respondents were asked in open-ended questions to indicate what they perceived to be the greatest barrier to CDTM and the greatest facilitator of CDTM. Logistic regression was used to assess associations between demographics and CDTM. To test for response bias, chi-square tests compared CDTM and demographics of early and late respondents. An a priori alpha of 0.05 was used for all statistical tests.

Of 1,024 surveys mailed, 84 were returned after failing to be delivered. Of the 293 responses received, 7 were incomplete, leaving 283 usable surveys (30.1% adjusted usable response rate). There were no significant differences in demographics or CDTM use in the earliest 1/3 and latest 1/3 of respondents indicating no response bias. Pharmacists were engaged in CDTM in 66 percent of hospitals. Most hospitals allowed pharmacists to order laboratory tests (58.7%), adjust drug strength (57.9%) and change frequency of administration (53.8%). Hospitals mostly permitted CDTM for Anticoagulation (52.4%), Infectious Diseases (44.8%) and Parenteral Nutrition (32.6%). It was seen that institution ownership, private hospitals were 3.3 (p