Brief report: Reducing inappropriate usage of stress ulcer prophylaxis among internal medicine residents

Liberman, Joshua D.; Whelan, Chad

doi:10.1111/j.1525-1497.2006.00435.x

Cited by 28 publications

(24 citation statements)

References 17 publications

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“…Therefore, SUP was significantly better practised in teaching hospitals. Such results are not surprising because teaching hospitals are more likely to follow guidelines and recommendations [63,64] . This study reinforces the results of previous studies undertaken in the Middle East.…”

mentioning

confidence: 79%

Stress ulcer prophylaxis guidelines: Are they being implemented in Lebanese health care centers?

Zeitoun

Zeineddine²,

Dimassi³

2011

WJGPT

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AIM:To evaluate the current practice of stress ulcer prophylaxis (SUP) in Lebanese Health care centers. METHODS:A multi-center prospective chart review study was conducted over 8 mo. A questionnaire was distributed to pharmacy students who collected data on demographics, SUP medications, dose, route, duration and associated risk factors. The appropriateness of SUP use was determined as per American Society of Health-System Pharmacists guidelines. Institutional review board approval was obtained from each hospital center. RESULTS:A total of 1004 patients were included. 67% of the patients who received prophylaxis did not have an indication for SUP. The majority (71.6%) of the patients who were administered parenteral drugs can tolerate oral medications. Overall, the regimen of acid-suppressant drugs was suboptimal in 87.6% of the sample. This misuse was mainly observed in nonteaching hospitals. CONCLUSION:This study highlighted the need, in Lebanese hospitals, to establish clinical practice guidelines for the use of SUP; mainly in non-critical care settings.

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confidence: 79%

Stress ulcer prophylaxis guidelines: Are they being implemented in Lebanese health care centers?

Zeitoun

Zeineddine²,

Dimassi³

2011

WJGPT

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“…5,[10][11][12] We found much lower baseline levels of discharge with inappropriate AST prescriptions. Although having pharmacy students on the patient care teams may have reduced the number of patients discharged with inappropriate AST prescriptions, this finding would be incidental.…”

Section: Discussionmentioning

confidence: 76%

Pharmacy Student Impact on Inappropriate Prescribing of Acid Suppressive Therapy

Carey

Cross

Silva

et al. 2011

American Journal of Pharmaceutical Education

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Objective. To examine the impact that having pharmacy students on internal medicine patient care teams had on inappropriate prescribing of acid suppressive therapy (AST). Methods. In this observational cohort study, internal medicine patients who received care from teams with a pharmacy student were compared to patients who received care from teams without a pharmacy student. The primary endpoint was proportion of patients on inappropriate AST. Results. The overall proportion of patients receiving inappropriate AST was 24.4%. There was no significant difference between patients seen by teams with a pharmacy student and those seen by teams without a pharmacy student. The proportion of patients discharged with new inappropriate AST prescriptions was lower after pharmacy student review, though not significantly (6.1% vs. 9.4%, p 5 0.07). Pharmacy student reviews shortened the median duration of inappropriate AST by 1.5 days (6 vs. 8.5 days, p 5 0.025). Conclusions. Patient care teams on which pharmacy students performed medication reviews had a reduced duration of inappropriate use of AST in patients.

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“…(3) The pharmacy should have a pivotal role in making sure these guidelines are adhered to. Liberman and Whelan [21] were able to reduce the rate of inappropriate SUP significantly by sparing one out of every 3 patients an inappropriate medication by conducting a low-cost educational intervention based on the principles of practice-based learning and improvement. Also pharmacy intervention has been shown to reduce inappropriate AST use [22–24].…”

Section: Discussionmentioning

confidence: 99%

Identifying Risk Factors Associated with Inappropriate Use of Acid Suppressive Therapy at a Community Hospital

Singh

Bodukam

Saigal

et al. 2016

Gastroenterology Research and Practice

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Purpose. By examining the prescribing patterns and inappropriate use of acid suppressive therapy (AST) during hospitalization and at discharge we sought to identify the risk factors associated with such practices. Methods. In this retrospective observational study, inpatient records were reviewed from January 2011 to December 2013. Treatment with AST was considered appropriate if the patient had a known specific indication or met criteria for stress ulcer prophylaxis. Results. In 2011, out of 58 patients who were on AST on admission, 32 were newly started on it and 23 (72%) were inappropriate cases. In 2012, out of 97 patients on AST, 61 were newly started on it and 51 (84%) were inappropriate cases. In 2013, 99 patients were on AST, of which 48 were newly started on it and 36 (75%) were inappropriate cases. 19% of the patients inappropriately started on AST were discharged on it in three years. Younger age, female sex, and 1 or more handoffs between services were significantly associated with increased risk of inappropriate AST. Conclusion. Our findings reflect inappropriate prescription of AST which leads to increase in costs of care and unnecessarily puts the patient at risk for potential adverse events. The results of this study emphasize the importance of examining the patient's need for AST at each level of care especially when the identified risk factors are present.

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Brief report: Reducing inappropriate usage of stress ulcer prophylaxis among internal medicine residents

Abstract: BACKGROUND: Many inpatients receive stress ulcer prophylaxis (SUP) inappropriately. This indiscriminate usage increases costs and avoidable side-effects. Practice-based learning and improvement (PBLI) methodology may improve compliance with published guidelines.

Cited by 28 publications

References 17 publications

Stress ulcer prophylaxis guidelines: Are they being implemented in Lebanese health care centers?

Stress ulcer prophylaxis guidelines: Are they being implemented in Lebanese health care centers?

Pharmacy Student Impact on Inappropriate Prescribing of Acid Suppressive Therapy

Identifying Risk Factors Associated with Inappropriate Use of Acid Suppressive Therapy at a Community Hospital

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