Impact of a clinical pharmacist stress ulcer prophylaxis management program on inappropriate use in hospitalized patients
| Autor: | Roxanne Garcia-Orr, Laura M. Wicks, Richard Gerkin, Clint S. Anderson, Andrew S. Park, Mitchell S. Buckley, Dale Bikin, Jeffrey F. Barletta, Sandra L. Kane-Gill, Cheryl W. O'Malley |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty Peptic Ulcer medicine.drug_class Hospitalized patients Pharmacist Proton-pump inhibitor Inappropriate Prescribing Pharmacists law.invention law Cost Savings Stress Physiological Medicine Humans Intensive care medicine Aged Retrospective Studies business.industry Stress ulcer Proton Pump Inhibitors General Medicine Middle Aged medicine.disease Anti-Ulcer Agents Intensive care unit Cost savings Clinical pharmacy Hospitalization Intensive Care Units Histamine H2 Antagonists General ward business Hospital Units |
| Zdroj: | The American journal of medicine. 128(8) |
| ISSN: | 1555-7162 |
| Popis: | Appropriate utilization of stress ulcer prophylaxis should be limited to high-risk, intensive care unit (ICU) patients. However, inappropriate stress ulcer prophylaxis use among all hospitalized patients remains a concern. The purpose of this study was to evaluate the clinical and economic impact of a novel pharmacist-managed stress ulcer prophylaxis program in ICU and general ward patients.This retrospective, pre- and poststudy design was conducted in adult ICU and general ward patients at a large academic medical center between January 1, 2011 and January 31, 2012 to compare the rates of inappropriate stress ulcer prophylaxis before and after the implementation of a pharmacist-led stress ulcer prophylaxis management program.A total of 1134 unique patients consisting of 16,415 patient days were evaluated. The relative reduction in the rate of inappropriate stress ulcer prophylaxis days after program implementation in ICU and general ward patients was 58.3% and 83.5%, respectively (P.001). The rates of ICU patients inappropriately continued on stress ulcer prophylaxis upon hospital discharge in the pre- and postimplementation groups were 29.9% and 3.6%, respectively (P.001), whereas general ward patients significantly decreased from 36.2% to 5.4% in the pre- and postimplementation groups, respectively (P .001). Total inpatient costs associated with all stress ulcer prophylaxis administered was $20,052.70 in the pre- and $3280.49 in the postimplementation group (P.001), resulting in an estimated cost savings of$200,000 annually. No differences in clinical outcomes were observed.The implementation of a pharmacist-managed stress ulcer prophylaxis program was associated with a decrease in inappropriate acid suppression rates during hospitalization and upon discharge, as well as significant cost savings. |
| Databáze: | OpenAIRE |
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