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

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dc.contributor.author Sheikh-Taha, Marwan
dc.contributor.author Alaeddine, Sarah en_US
dc.contributor.author Nassif, Julie en_US
dc.date.accessioned 2016-06-02T12:40:25Z
dc.date.available 2016-06-02T12:40:25Z
dc.date.copyright 2012 en_US
dc.date.issued 2016-06-02
dc.identifier.issn 2150-5349 en_US
dc.identifier.uri http://hdl.handle.net/10725/3936
dc.description.abstract AIM: To assess the appropriateness of prescribing acid suppressive therapy (AST) in a general medicine service in a tertiary care hospital. METHODS: In this retrospective observational study, we reviewed the inpatient records of all patients admitted to the general medical service in a tertiary care hospital in Beirut, Lebanon, from April 1 to May 31, 2011. Treatment with AST was considered appropriate if the patient had a specific indication or appropriate treatment purpose [e.g., gastro-esophageal reflux disease (GERD), peptic ulcer disease, dyspepsia, acute or suspected gastrointestinal (GI) bleeding]. Appropriate administration of stress ulcer prophylaxis (SUP) was derived from an internal guideline that is based on the American Society of Health System Pharmacists guidelines. Prophylaxis was considered appropriate if a patient had 1 absolute indication (coagulopathy or requiring mechanical ventilation), or 2 or more relative indications (sepsis, occult bleeding, use of high dose corticosteroids, recent use of non-steroidal anti-inflammatory drugs for more than 3 mo, renal or liver failure, enteral feeding and anticoagulant use). RESULTS: Of the 153 patient admissions during the study period, 130 patients (85%) were started on AST, out of which 11 (8.5%) had a diagnosis that supports the use of this therapy (GI bleed, gastritis and GERD), 16 (12.3%) had an absolute indication for SUP, 59 (45.4%) had 2 or more relative indications for SUP, and 44 (33.8%) received AST without an appropriate indication. In addition, one patient with an absolute indication for SUP and four with two or more relative indications did not receive AST. Rabeprazole was the most frequently used AST (59.2%), followed by omeprazole (24.6%), esomeprazole (11.6%) and ranitidine (4.6%). The dose of AST was appropriate in 126 patients (96.9%) and the route of administration was appropriate in 123 patients (94.6%). Fifteen of the admitted patients (10%) were discharged on AST, 7 of which (47%) did not have an appropriate indication. CONCLUSION: 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 en_US
dc.language.iso en en_US
dc.title Use of acid suppressive therapy in hospitalized non-critically ill patients en_US
dc.type Article en_US
dc.description.version Published en_US
dc.author.school SOP en_US
dc.author.idnumber 199410150 en_US
dc.author.department Pharmacy Practice Department en_US
dc.description.embargo N/A en_US
dc.relation.journal World Journal of Gastrointestinal Pharmacology and Therapeutics en_US
dc.journal.volume 3 en_US
dc.journal.issue 6 en_US
dc.article.pages 93-96 en_US
dc.keywords Acid suppressive therapy en_US
dc.keywords Stress ulcer prophylaxis en_US
dc.keywords Proton pump inhibitors en_US
dc.keywords Histamine-2 receptor antagonists en_US
dc.identifier.doi http://dx.doi.org/10.4292/wjgpt.v3.i6.93 en_US
dc.identifier.ctation Sheikh-Taha, M., Alaeddine, S., & Nassif, J. (2012). Use of acid suppressive therapy in hospitalized non-critically ill patients. World Journal of Gastrointestinal Pharmacology and Therapeutics, 3(6), 93. en_US
dc.author.email marwan.taha@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3596518/ en_US
dc.orcid.id https://orcid.org/0000-0002-8037-1201 en_US

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