J Clin Outcomes Manage
Evaluation of stress ulcer prophylaxis in a family medicine residency inpatient service
Kehr HA, Griffiths CL, Haynes W, Everhart S, Messick BH
Abstract: Objective: To determine if stress ulcer prophylaxis (SUP) is being used in accordance with the best current evidence and to evaluate if appropriate use can be improved with educational interventions.? Methods: A prospective, observational study was conducted at a regional not-for-profit hospital with an affiliated family medicine residency program. Eligible patients were > 18 years of age and the family medicine residency inpatient service was the admitting team. Patients were excluded if they had acid peptic disease or were taking a proton pump inhibitor (PPI) or histamine2-receptor antagonist (H2RA) prior to admission. Appropriate SUP use was defined based on the 1999 ASHP SUP guidelines. Data collection took place at baseline and at 1 and 4 months after an educational intervention. Results: Data were collected for 100 consecutive patients in each data collection period. A statistically significant decrease in inappropriate use of SUP was noted throughout the study (baseline, 19 cases; at 1 month, 11; at 4 months, 2; P < 0.002). One patient in the 4-month data collection period was determined to have an appropriate indication for SUP and did appropriately receive SUP.?The most common acid suppression agent used for prophylaxis or treatment was a PPI.? Conclusion: Stress ulcer prophylaxis was inappropriately being prescribed in our family medicine inpatient service prior to educational intervention. Educational interventions regarding the appropriate use of SUP can decrease inappropriate use on a family medicine inpatient service
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