The Impact of a New Best Practice Advisory on the Management of Diabetic Ketoacidosis

Background: According to the Center for Disease Control and Prevention, diabetic ketoacidosis (DKA) hospitalization rates have been steadily increasing. Due to the increasing incidence and the economic impact associated with its morbidity and treatment, effective management is key. We aimed to streamline the management of DKA in our intensive care units (ICU) by implementing a Best-Practice Advisory (BPA) that notifies providers when DKA has resolved. Methods: A BPA was implemented on 9/15/2018. We conducted a retrospective review of patients admitted to the ICU with DKA a year before and after 9/15/2018. Adults (≥18 age) meeting DKA criteria on admission and treated with continuous insulin infusion (CII) were included. Pre-intervention group included patients admitted before BPA implementation and post-intervention group included patients admitted after. Summary and univariate analyses were performed. Results: A total of 282 patients were included; 162 (57%) pre-intervention and 120 (43%) post-intervention. Mean (±SD) age was 44 (±17) years. There was no significant difference in baseline characteristics such as age, sex, race, BMI, HbA1c, initial blood glucose, anion gap or bicarbonate concentration between both groups (p>0.05). Mean (±SD) total time on CII in hours was significantly lower in the post-intervention group 14.8 (±7.7) vs 17.5 (±14.3) p=0.041, 95% CI: 0.11-5.3. The incidence of hypoglycemia was lower in the post-intervention group n=4 (3%) vs 17 (10%), p=0.024. There was no significant difference in hypokalemia, mortality, LOS or ICU stay between both groups (p>0.05). Conclusions: The BPA introduced in our DKA management algorithm successfully reduced total time on insulin and the incidence of hypoglycemia.

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46. Antimicrobial Stewardship’s Selective Antibiotic Suppression Does Not Lead to Adverse Outcomes in Neutropenic Patients with Gram-Negative Bacteremia

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.091 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S46-S46

Author(s):

Anna Witt ◽

Mason G Harper ◽

Juan Carlos Rico Crescencio ◽

Ryan K Dare ◽

Mary Burgess

Keyword(s):

Intervention Group ◽

Adverse Outcomes ◽

Post Intervention ◽

Gram Negative ◽

Narrow Spectrum ◽

Stewardship Program ◽

Significant Difference ◽

Before And After ◽

Gram Negative Bacteremia ◽

Post Intervention Group

Abstract Background An antimicrobial stewardship program (ASP) strategy to minimize the use of overly broad antimicrobials is to suppress specific antimicrobial susceptibility results when isolates are sensitive to narrow antibiotics. There is limited data on possible adverse outcomes of this method. Patients with febrile neutropenia (FN) and gram-negative bacteremia (GNB) whose culture is sensitive to non-pseudomonal antibiotics still require broader pseudomonal coverage to treat the syndrome of FN. We evaluated if ASP suppression of anti-pseudomonal antibiotics adversely affects patients with FN and GNB. Methods In February 2018, our institution’s ASP began suppressing cefepime and meropenem susceptibility results from E. coli, Klebsiella spp, and Proteus spp when sensitive to cefepime (MIC ≤ 2), ceftriaxone and ceftazidime. We performed a retrospective analysis of patients with FN and GNB from 2016 – 2020 to evaluate the appropriateness of antibiotic regimens before and after the ASP intervention. Antibiotic regimens were deemed inappropriate if the patient was de-escalated to a narrow-spectrum, non-pseudomonal agent while neutropenic. Of 338 inpatient encounters identified with any bacteremia and FN, 49 were due to non-Pseudomonas, non-ESBL GNB, 20 before and 29 after the intervention. Sixteen of the 29 post-intervention patients were excluded, as their isolates did not meet suppression criteria. This resulted in a total of 13 patients in the post-intervention group. Results After culture susceptibility reports were released, 3 out of 20 patients in the pre-intervention group (15%) and 4 out of 13 patients in the post-intervention group (30.8%) were inappropriately tailored to narrow-spectrum antibiotics (p=0.39). There was no significant difference in 30-day mortality, 10.0% pre- and 0% post-intervention (p=0.50), or amount of meropenem prescribed, 45% pre- and 38.5% post-intervention (p=0.74). Conclusion These data show no significant difference in inappropriate antibiotic regimens prescribed for patients with FN and GNB after ASP antibiotic suppression was implemented. 30-day mortality was also not affected. The ASP intervention did not decrease meropenem prescriptions in this patient group, which may be appropriate. Larger studies are needed to verify these findings. Disclosures Ryan K. Dare, MD, MS, Accelerate Diagnostics, Inc (Research Grant or Support) Mary Burgess, MD, Pfizer Inc (Grant/Research Support)

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The impact of an innovative pharmacist-led inpatient opioid de-escalation intervention in post-operative orthopedic patients

Journal of Opioid Management ◽

10.5055/jom.2020.0565 ◽

2020 ◽

Vol 16 (3) ◽

pp. 167-176

Author(s):

Thuy Bui, BPharm ◽

Richard Grygiel, MPharm ◽

Alex Konstantatos, MB BS (Hons), FANZCA, Dip Obs, MRCA ◽

Nick Christelis ◽

Susan Liew, MB BS (Hons), FRACS ◽

...

Keyword(s):

Pain Intensity ◽

Intervention Group ◽

Public Health Problem ◽

Prescription Opioid ◽

Opioid Use ◽

Post Intervention ◽

Before And After ◽

Orthopedic Patients ◽

The Impact ◽

Post Intervention Group

Objective: Many patients are discharged from hospital after surgery with excessive doses of opioid, and prescription opioid addiction has become a serious public health problem. Inpatient opioid de-escalation performed by clinical pharmacists may assist in reducing opioids before discharge. We aimed to evaluate whether clinical pharmacist-led opioid de-escalation for inpatients after orthopedic surgery led to significant reductions in opioid use at discharge, without resulting in greater pain intensity and side effects.Design: This retrospective pre-/post-intervention study evaluated patients before and after implementation of a pharmacist-led opioid de-escalation service.Setting: A major tertiary institution.Participants: Ninety eight participants underwent de-escalation, and 98 controls received standard care following orthopedic surgery.Intervention: Pharmacist-led opioid de-escalation was initiated after discharge from the institution's Acute Pain Service.Main outcome measure: Primary outcome was total morphine oral equivalence (MOE) required in the 24-hours before discharge between the two groups. Secondary outcomes included pain intensity scores and opioid-related side effects. Results: The post-intervention group used significantly less opioids in the 24 hours preceding discharge compared with the precohort (total MOE 30 vs 45 mg; p = 0.025).There were no differences in pain intensity at rest (p = 0.19) or with movement (p = 0.19). Cases experienced significantly less constipation (29 vs 49 percent; p = 0.004); no differences were observed for other side effects.Discussion: We observed statistically similar pain intensity ratings, in the setting of significantly lowered opioid doses among the post-intervention group prior to discharge.Conclusion: Pharmacist-led inpatient opioid de-escalation is effective, does not increase pain intensity, and reduces constipation. Hospitals should explore the viability of extending pharmacist-led opioid de-escalation to other surgical patients and following hospital discharge, aiming for opioid cessation.

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87. Utilization of Methicillin-Sensitive/Resistant Staphylococcus aureus Nares Screen to Decrease Vancomycin and Linezolid Use in Hospitalized Patients with Respiratory Infections

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.132 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S60-S60

Author(s):

Noor F Zaidan ◽

Rachel S Britt ◽

David Reynoso ◽

R Scott Ferren

Keyword(s):

Staphylococcus Aureus ◽

Respiratory Infections ◽

Intervention Group ◽

Kidney Injury ◽

Post Intervention ◽

Gram Positive ◽

Stewardship Program ◽

Screening Protocol ◽

The Impact ◽

Post Intervention Group

Abstract Background Pharmacist-driven protocols for utilization of methicillin-resistant Staphylococcus aureus (MRSA) nares screenings have shown to decrease duration of empiric gram-positive therapy and rates of acute kidney injury (AKI) in patients with respiratory infections. This study evaluated the impact of a pharmacist-driven MRSA nares screening protocol on duration of vancomycin or linezolid therapy (DT) in respiratory infections. Methods Patients aged 18 years and older with a medication order of vancomycin or linezolid for respiratory indication(s) were included. The MRSA nares screening protocol went into effect in October 2019. The protocol allowed pharmacists to order an MRSA nares polymerase chain reaction (PCR) for included patients, while the Antimicrobial Stewardship Program (ASP) made therapeutic recommendations for de-escalation of empiric gram-positive coverage based on negative MRSA nares screenings, if clinically appropriate. Data for the pre-intervention group was collected retrospectively for the months of October 2018 to March 2019. The post-intervention group data was collected prospectively for the months of October 2019 to March 2020. Results Ninety-seven patients were evaluated within both the pre-intervention group (n = 50) and post-intervention group (n = 57). Outcomes for DT (38.2 hours vs. 30.9 hours, P = 0.601) and AKI (20% vs. 14%, P = 0.4105) were not different before and after protocol implementation. A subgroup analysis revealed a significant reduction in DT within the pre- and post-MRSA PCR groups (38.2 hours vs. 24.8 hours, P = 0.0065) when pharmacist recommendations for de-escalation were accepted. Conclusion A pharmacist-driven MRSA nares screening protocol did not affect the duration of gram-positive therapy for respiratory indications. However, there was a reduction in DT when pharmacist-driven recommendations were accepted. Disclosures All Authors: No reported disclosures

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600. Decreased Hospital Readmission After Programmatic Strengthening of an Outpatient Parenteral Antimicrobial Therapy (OPAT) Program

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.794 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S362-S363

Author(s):

Gaurav Agnihotri ◽

Alan E Gross ◽

Minji Seok ◽

Cheng Yu Yen ◽

Farah Khan ◽

...

Keyword(s):

Hospital Readmission ◽

Multinomial Logistic Regression ◽

Univariate Analysis ◽

Tertiary Care ◽

Intervention Group ◽

Care Hospital ◽

Full Time ◽

Post Intervention ◽

Before And After ◽

The Impact

Abstract Background Although it is recommended that an OPAT program should be managed by a formal OPAT team that supports the treating physician, many OPAT programs face challenges in obtaining necessary program staff (i.e nurses or pharmacists) due to limited data examining the impact of a dedicated OPAT team on patient outcomes. Our objective was to compare OPAT-related readmission rates among patients receiving OPAT before and after the implementation of a strengthened OPAT program. Methods This retrospective quasi-experiment compared adult patients discharged on intravenous (IV) antibiotics from the University of Illinois Hospital before and after implementation of programmatic changes to strengthen the OPAT program. Data from our previous study were used as the pre-intervention group (1/1/2012 to 8/1/2013), where only individual infectious disease (ID) physicians coordinated OPAT. Post-intervention (10/1/2017 to 1/1/2019), a dedicated OPAT nurse provided full time support to the treating ID physicians through care coordination, utilization of protocols for lab monitoring and management, and enhanced documentation. Factors associated with readmission for OPAT-related problems at a significance level of p< 0.1 in univariate analysis were eligible for testing in a forward stepwise multinomial logistic regression to identify independent predictors of readmission. Results Demographics, antimicrobial indications, and OPAT administration location of the 428 patients pre- and post-intervention are listed in Table 1. After implementation of the strengthened OPAT program, the readmission rate due to OPAT-related complications decreased from 17.8% (13/73) to 6.5% (23/355) (p=0.001). OPAT-related readmission reasons included: infection recurrence/progression (56%), adverse drug reaction (28%), or line-associated issues (17%). Independent predictors of hospital readmission due to OPAT-related problems are listed in Table 2. Table 1. OPAT Patient Demographics and Factors Pre- and Post-intervention Table 2. Factors independently associated with hospital readmission in OPAT patients Conclusion An OPAT program with dedicated staff at a large academic tertiary care hospital was independently associated with decreased risk for readmission, which provides critical evidence to substantiate additional resources being dedicated to OPAT by health systems in the future. Disclosures All Authors: No reported disclosures

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Assessment of Direct Oral Anticoagulant Prescribing and Monitoring Pre- and Post-Implementation of a Pharmacy Protocol at a Community Teaching Hospital

Hospital Pharmacy ◽

10.1310/hpj5203-207 ◽

2017 ◽

Vol 52 (3) ◽

pp. 207-213 ◽

Cited By ~ 6

Author(s):

Christina Miele ◽

Mary Taylor ◽

Aditi Shah

Keyword(s):

Teaching Hospital ◽

Vitamin K Antagonists ◽

Intervention Group ◽

Adult Patients ◽

Patient Specific ◽

Post Intervention ◽

Appropriate Prescribing ◽

The Impact ◽

Post Intervention Group ◽

Community Teaching

Background Direct oral anticoagulants (DOACs) have become popular alternatives to vitamin K antagonists for the treatment and prevention of thromboembolic diseases; however, there are limited data regarding the appropriate use of DOACs in clinical practice. To ensure safety and efficacy of these medications, it is important that decisions regarding their use in patients rely on the available evidence. Objective The purpose of this study was to evaluate the appropriateness of DOAC prescribing in adult patients before and after the implementation of a pharmacist-driven DOAC protocol. Methods Data were collected on adult patients admitted to a community teaching hospital who received DOAC therapy for at least 2 days between January and March 2015 (pre-intervention group) and between January and March 2016 (post-intervention group). These data were analyzed to measure inappropriately prescribed DOACs, defined based on DOAC indication, renal function, drug interactions, and other pertinent patient-specific factors. Prior to the start of data collection for the post-intervention group, a pharmacist-driven protocol was developed and implemented. DOAC education was provided to pharmacists, including an evidence-based prescribing table to guide appropriate DOAC therapy. Comparisons were made between the pre-intervention and post-intervention groups to determine the impact of the pharmacist-driven service on appropriate DOAC prescribing. Results Fifty patients were analyzed in the pre-intervention group compared with 85 patients in the post-intervention group, with a total of 333 and 816 doses administered, respectively. Of the total doses administered, 32.4% were considered inappropriate in the pre-intervention group compared with 13.8% in the post-intervention group (adjusted odds ratio [OR], 0.42, 95% CI, 0.19-0.96; p = 0.039). Conclusions Implementing a pharmacist-driven DOAC service significantly improved appropriate prescribing of these agents. Provider education regarding DOAC use is essential to further increase appropriate prescribing of DOACs, optimize patients' therapy, and prevent adverse drug events.

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An Electronic Alert for HIV Screening in the Emergency Department Increases Screening but not the Diagnosis of HIV

Applied Clinical Informatics ◽

10.4338/aci-2013-09-ra-0075 ◽

2014 ◽

Vol 05 (01) ◽

pp. 299-312 ◽

Cited By ~ 7

Author(s):

N. Liu ◽

J. Sperling ◽

R. Green ◽

S. Clark ◽

D. Vawdrey ◽

...

Keyword(s):

Emergency Department ◽

New York ◽

Hiv Testing ◽

Intervention Group ◽

Hiv Screening ◽

Intervention Period ◽

Post Intervention ◽

Hiv Test ◽

The Impact ◽

Post Intervention Group

SummaryObjective: Based on US. Centers for Disease Control and Prevention recommendations, New York State enacted legislation in 2010 requiring healthcare providers to offer non-targeted human immunodeficiency virus (HIV) testing to all patients aged 13–64. Three New York City adult emergency departments implemented an electronic alert that required clinicians to document whether an HIV test was offered before discharging a patient. The purpose of this study was to assess the impact of the electronic alert on HIV testing rates and diagnosis of HIV positive individuals.Methods: During the pre-intervention period (2.5–4 months), an electronic “HIV Testing” order set was available for clinicians to order a test or document a reason for not offering the test (e.g., patient is not conscious). An electronic alert was then added to enforce completion of the order set, effectively preventing ED discharge until an HIV test was offered to the patient. We analyzed data from 79,786 visits, measuring HIV testing and detection rates during the pre-intervention period and during the six months following the implementation of the alert.Results: The percentage of visits where an HIV test was performed increased from 5.4% in the pre-intervention period to 8.7% (p<0.001) after the electronic alert. After the implementation of the electronic alert, there was a 61% increase in HIV tests performed per visit. However, the percentage of patients testing positive per total patients-tested was slightly lower in the post-intervention group than the pre-intervention group (0.48% vs. 0.55%), but this was not significant. The number of patients-testing positive per total-patient visit was higher in the post-intervention group (0.04% vs. 0.03%).Conclusions: An electronic alert which enforced non-targeted screening was effective at increasing HIV testing rates but did not significantly increase the detection of persons living with HIV. The impact of this electronic alert on healthcare costs and quality of care merits further examination.Citation: Schnall R, Liu N, Sperling J, Green R, Clark S, Vawdrey D. An electronic alert for HIV screening in the emergency department increases screening but not the diagnosis of HIV. Appl Clin Inf 2014; 5: 299–312 http://dx.doi.org/10.4338/ACI-2013-09-RA-0075

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Impact of Health Education on Mothers' Knowledge of Preventive Health Practices

Tropical Doctor ◽

10.1177/004947559702700405 ◽

1997 ◽

Vol 27 (4) ◽

pp. 199-202 ◽

Cited By ~ 5

Author(s):

Mubina Agboatwalla ◽

Dure Samin Akram

Keyword(s):

Health Education ◽

Breast Feeding ◽

Intervention Study ◽

Intervention Group ◽

Preventive Health ◽

Slum Area ◽

Post Intervention ◽

Community Based ◽

Significant Difference ◽

The Impact

A prospective community-based intervention study was conducted in a slum area of Karachi, Pakistan, with the objective of evaluating the impact of health education on the knowledge of mothers. One hundred and fifty households were studied in the intervention and the same in the non-intervention group. The post intervention knowledge scores of the mothers showed a significant difference of P < 0.05. Nearly 50.7% mothers in the intervention group knew of at least four diseases against which vaccination is given as compared to the non-intervention group ( P < 0.05). Similarly, mothers in the intervention group were more aware about the advantages of breast feeding, signs of dehydration, measures for prevention of measles and tuberculosis as compared to the non-intervention group ( P < 0.05). Finally, a comparison was made between the pre- and post-intervention scores between the two groups. The score in the non-intervention group changed from 11.5 to 16.1 ( P > 0.05) as compared to the intervention group in which it changed from 10.2 to 32.2 ( P < 0.05).

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102. Effects of an Antimicrobial Stewardship-guided MRSA Nasal Screening Review on Vancomycin Utilization for Respiratory Infections: A Quasi-Experimental Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.147 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S65-S65

Author(s):

Ross Pineda ◽

Meganne Kanatani ◽

Jaime Deville

Keyword(s):

Antimicrobial Stewardship ◽

Respiratory Infections ◽

Intervention Group ◽

Small Sample ◽

Post Intervention ◽

Predictive Values ◽

Days Of Therapy ◽

Significant Difference ◽

Quasi Experimental ◽

The Impact

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) remains a significant pathogen in patients with respiratory infections. Guidelines recommend empiric MRSA coverage in patients at increased risk, resulting in substantial vancomycin use. Recent literature highlights the use of MRSA nasal assays as a rapid screening tool for MRSA pneumonia, demonstrating high negative predictive values and allowing for shorter empiric coverage. We aimed to evaluate the impact of MRSA nasal screening review by the antimicrobial stewardship program (ASP) on vancomycin utilization for respiratory infections. Methods This was a retrospective, quasi-experimental, pre-post intervention study. The intervention saw the addition of an MRSA screening review tool into the ASP electronic record, highlighting patients on vancomycin (actively or recently administered) with a negative MRSA screening. Vancomycin days of therapy (DOT) was collected for all orders indicated for a respiratory infection in the two weeks following a negative screening. Additional outcomes include vancomycin total dose and DOT per 1,000 patient days. Outcomes were compared via independent samples t-tests. Results 1,110 MRSA screenings resulted across 2 months, of which the majority were excluded for either not having vancomycin ordered, or for having vancomycin ordered for a non-respiratory indication, leaving 37 and 35 evaluable screenings in the pre- and post-intervention groups, respectively. Regarding vancomycin DOT, we did not identify a significant difference between pre- and post-intervention groups with respective means of 2.45 (SD=1.52) and 2.14 (SD=1.12) (p=0.35). We identified a total 8.78 vancomycin DOT per 1,000 patient days in the pre-intervention group versus 6.69 in the post-intervention group. Conclusion ASP-guided review of MRSA screenings was associated with a nonsignificant decrease in mean vancomycin DOT and lower total DOT per 1,000 patient days for respiratory infections following a negative screen. Given the recent implementation of our intervention, our analysis covered a small sample size, highlighting the need for continued data collection. MRSA screenings are not always fully or immediately utilized in our institution, demonstrating room to de-escalate MRSA-targeted antibiotics. Disclosures All Authors: No reported disclosures

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87. Effectiveness of a Best Practice Advisory in Reducing Inappropriate Urine Cultures

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.289 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S159-S159

Author(s):

Margaret Cooper ◽

Katherine C Shihadeh ◽

Cory Hussain ◽

Timothy C Jenkins

Keyword(s):

Pregnant Women ◽

Best Practice ◽

Urine Culture ◽

Asymptomatic Bacteriuria ◽

Urinary Symptoms ◽

Intervention Period ◽

Post Intervention ◽

Absolute Increase ◽

Practice Advisory ◽

The Impact

Abstract Background Inappropriate urine cultures can contribute to overutilization of antibiotic treatment for asymptomatic bacteriuria. The objective of this study was to evaluate the appropriateness of urine cultures and the impact of a clinical decision support (CDS) intervention. Methods The CDS intervention involved embedding three questions in the urine culture order: whether the patient has fever, leukocytosis or urinary symptoms. When the answer to all three questions is no, a best practice advisory (BPA) alerts the provider that the patient may not meet criteria for a urine culture and suggests cancellation of the order. Cultures obtained in patients experiencing fever, leukocytosis, or urinary symptoms, and those who were pregnant, undergoing invasive urologic procedure, or < 3 years old were classified as appropriate. We performed a quasi-experimental study assessing appropriateness of urine cultures before and after implementation of the BPA. The pre-intervention period was 5/9/19 to 7/31/20 and the intervention period was 2/3/21 to 4/27/21. Random samples of 100 cases from pre- and post-intervention were reviewed to assess appropriateness. Results There were 12,679 and 8,270 urine cultures performed pre-intervention and post-intervention, respectively. In 100 cases reviewed pre-intervention, 74% of the cultures were appropriate. Of these, 54% were ordered due to fever or leukocytosis, 50% due to urinary symptoms, and 12% in pregnant women. Post-intervention, the BPA fired on 458 orders and 106 (23%) were subsequently discontinued. Of the 100 cases reviewed post-intervention, 5 orders were discontinued after the BPA fired. Of the remaining 95 cultures, 78% were appropriate. Of these, 41% were ordered for fever or leukocytosis, 69% for urinary symptoms, and 11% in pregnant women. The change in the proportion of appropriate cultures pre- and post-intervention was not statistically significant (74% vs 78%, respectively, p=0.906). Conclusion In nearly one quarter of urine cultures performed, there was not an appropriate indication. Our intervention led to cancellation of 23% urine culture orders and resulted in an absolute increase in 4% of the cultures being ordered appropriately. However, the change in appropriateness was not statistically significant. Disclosures All Authors: No reported disclosures

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The impact of a peer-based education on fruits and vegetables intake among housewives

Journal of Health Population and Nutrition ◽

10.1186/s41043-021-00278-3 ◽

2021 ◽

Vol 40 (1) ◽

Author(s):

Roya Sheybani ◽

Zahra Hosseini ◽

Sayed Hossein Davoodi ◽

Teamur Aghamolaei ◽

Amin Ghanbarnejad

Keyword(s):

Self Efficacy ◽

Fruits And Vegetables ◽

Group Discussion ◽

Peer Education ◽

Intervention Group ◽

Control Group ◽

Post Intervention ◽

Significant Difference ◽

Quasi Experimental ◽

The Impact

Abstract Background Evidence indicates the lower intake of fruits and vegetables than the recommended daily amount. Study aimed at determining the effects of peer education intervention on the consumption of fruits and vegetable in housewives. Methods A quasi-experimental was conducted with 130 housewives referring to health care centers in Bandar Abbas, Iran. Sixty-five subjects were recruited in each of the intervention and the control groups. Intervention group were divided into three subgroups each receiving a seven-sessions educational programs (lecturing and group discussion) through peers about the importance of benefits of fruits and vegetables consumption. Participants were followed for two months. Data were collected using a questionnaire in two stages of pre- and post-intervention. Differences in the outcome before and after the intervention were tested using T-test and paired T-test. Results The daily servings of fruits and vegetables in the intervention group increased from 1.73 to 4.20 and in the control group from 1.96 to 2.16; a statistically significant difference was also observed between the groups (P < 0.001). After the intervention benefits and self-efficacy of fruits and vegetables consumption significantly increased and perceived barriers of fruits and vegetables consumption significantly decreased in the intervention group (P < 0.001). Conclusion Peer education improves benefits and self-efficacy, reduces barriers, and increases the daily servings of fruits and vegetables in housewives.

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