Use of acid suppressive therapy in hospitalized non-critically ill patients

Sheikh-Taha, Marwan; Alaeddine, Sarah; Nassif, Julie

doi:10.4292/wjgpt.v3.i6.93

Cited by 21 publications

(23 citation statements)

References 14 publications

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“…The most prescribed drug was ranitidine, a finding that does not align with what can be found in the literature, where PPI's are on top (24,25,32,33). Nonetheless, we must mention that both oral and intravenous omeprazole were the antiulcer drugs with the highest accumulated cost in our study.…”

Section: Discussioncontrasting

confidence: 51%

“…The number of patients included (n = 778) greatly exceeds that of other described studies (24,(26)(27)(28). New research should be carried out on antiulcer prescriptions after hospital discharge, and comparisons of adequate prescribing at university hospitals vs. non-academic hospitals, as well as evaluating the impact of implementing drug prescription guidelines (27,28,34,35).…”

Section: Discussionmentioning

confidence: 99%

“…All these data on prescriptions are higher than those found in our population. Although most of these studies are old and based on evidence available at the time, the new scientific information on recommended use of antiulcer medications is one strength of this research regarding previous ones (20)(21)(22)(23)(24)(25)(26)(27)(28).…”

Section: Discussionmentioning

confidence: 99%

“…We must mention that we included multiple diagnoses, procedures and treatments as an indication for antiulcer use; this might also have contributed to a reduced inappropriate use of antiulcer drugs in comparison to other studies (20)(21)(22)(23)(24)(25)(26)(27)(28).…”

Section: Discussionmentioning

confidence: 99%

“…Nardino et al and various studies in countries like Saudi Arabia, the United States of America and Europe showed inadequate indications for antiulcer medications (PPI's and antiH2) that ranged between 40.0 % and 73.0 %, with variations in the health centers' care level and the populations studied. Other studies analyzed cases of stress ulcer prophylaxis, which showed 22.0 % to 33.8 % of prescriptions were inappropriate (20)(21)(22)(23)(24)(25)(26), or the unjustified formulation of antiulcer medication at the time of hospital discharge ranging from 24.0 % to 69.0 % (27,28), this being a new point of interest for future research. All these data on prescriptions are higher than those found in our population.…”

Section: Discussionmentioning

confidence: 99%

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An economic analysis of inadequate prescription of antiulcer medications for in-hospital patients at a third level institution in Colombia

Machado‐Alba

Castrillón-Spitia

Londoño-Builes³

et al. 2014

Rev. esp. enferm. dig.

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Introduction:The prescription and costs of antiulcer medications for in-hospital use have increased during recent years with reported inadequate use and underused.Aim: To determine the patterns of prescription-indication and also perform an economic analysis of the overcost caused by the non-justified use of antiulcer medications in a third level hospital in Colombia.Materials and methods: Cross-sectional study of prescription-indication of antiulcer medications for patients hospitalized in "Hospital Universitario San Jorge" of Pereira during July of 2012. Adequate or inadequate prescription of the first antiulcer medication prescribed was determined as well as for others prescribed during the hospital stay, supported by clinical practice guidelines from the Zaragoza I sector workgroup, clinical guidelines from the Australian Health Department, and finally the American College of Gastroenterology Criteria for stress ulcer prophylaxis. Daily defined dose per bed/day was used, as well as the cost for 100 beds/day and the cost of each bed/drug. A multivariate analysis was carried out using SPSS 21.0.Results: 778 patients were analyzed, 435 men (55.9 %) and 343 women, mean age 56.6 ± 20.1 years. The number of patients without justification for the prescription of the first antiulcer medication was 377 (48.5 %), and during the whole in-hospital time it was 336 (43.2 %). Ranitidine was the most used medication, in 438 patients (56.3 %). The cost/month for poorly justified antiulcer medications was € 3,335.6. The annual estimated cost for inadequate prescriptions of antiulcer medications was € 16,770.0 per 100 beds.Conclusion: A lower inadequate prescription rate of antiulcer medications was identified compared with other studies; however it was still high and is troubling because of the major costs that these inadequate prescriptions generates for the institution.

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Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

An economic analysis of inadequate prescription of antiulcer medications for in-hospital patients at a third level institution in Colombia

Machado‐Alba

Castrillón-Spitia

Londoño-Builes³

et al. 2014

Rev. esp. enferm. dig.

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Current practice of stress ulcer prophylaxis in a surgical patient cohort in a German university hospital

Rauch

Patrzyk

Heidecke

et al. 2021

Langenbecks Arch Surg

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Introduction Stress ulcer prophylaxis (SUP) has been a widespread practice both in intensive care units (ICU) and internal wards at the beginning of the twenty-first century. Clinical data suggests an important overuse of acid suppressive therapy (AST) for this indication. Data on current clinical practice of SUP in surgical patients in a non-ICU setting are spares. In the light of a growing number of reports on serious side effects of AST, this study evaluates the use of AST for SUP in a normal surgical ward in a German university hospital. Methods Between January 2016 and June 2016, SUP was analysed retrospectively in 1132 consecutive patients of the Department of Surgery of the Universitätsmedizin Greifswald. Results The patients managed with and without SUP were similar with respect to demographic data and treatment with anticoagulants, SSRI and glucocorticoids. Patients with SUP were treated more frequently by cyclooxygenase inhibiting drugs (NSAID, COX2-inhibitors), were more frequently treated in the intermediated care unit and had a longer hospital stay. Risk factors for the development of stress ulcers were similarly present in patient groups managed with and without SUP. About 85.7–99.6% of patients were given SUP without an adequate risk for stress ulcer development, depending on the method used for risk assessment. Discussion Still today, SUP is widely overused in non-ICU surgical patients. Information campaigns on risk factors for stress ulcer development and standard operating procedures for SUP are required to limit potential side effects and increased treatment costs.

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Inappropriate use of proton pump inhibitors in elderly patients discharged from acute care hospitals

Schepisi

Fusco

Sganga³

et al. 2016

The Journal of nutrition, health and aging

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Use of acid suppressive therapy in hospitalized non-critically ill patients

Abstract: AST is overused in hospitalized non-critically ill patients and many patients are discharged on unnecessary AST which can increase cost, drug interactions and adverse events. Potential interventions include implementation of institutional protocols and prescriber education.

Cited by 21 publications

References 14 publications

An economic analysis of inadequate prescription of antiulcer medications for in-hospital patients at a third level institution in Colombia

An economic analysis of inadequate prescription of antiulcer medications for in-hospital patients at a third level institution in Colombia

Current practice of stress ulcer prophylaxis in a surgical patient cohort in a German university hospital

Inappropriate use of proton pump inhibitors in elderly patients discharged from acute care hospitals

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