| Clinical and cost impact of intravenous proton pump inhibitor use in non-ICU patients. | |
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MedLine Citation:
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PMID: 20180237 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To assess the appropriateness of the indication and route of administration of proton-pump-inhibitors (PPIs) and their associated cost impact. METHODS: Data collection was performed prospectively during a 6-mo period on 340 patients who received omeprazole intravenously during their hospital stay in non-intensive care floors. Updated guidelines were used to assess the appropriateness of the indication and route of administration. RESULTS: Complete data collection was available for 286 patients which were used to assess intravenous (IV) PPIs utilization. Around 88% of patients were receiving PPIs for claimed stress ulcer prophylaxis (SUP) indication; of which, only 17% met the guideline criteria for SUP indication, 14% met the criteria for non-steroidal-anti-inflammatory drugs-induced ulcer prophylaxis, while the remaining 69% were identified as having an unjustified indication for PPI use. The initiation of IV PPIs was appropriate in 55% of patients. Half of these patients were candidates for switching to the oral dosage form during their hospitalization, while only 36.7% of these patients were actually switched. The inappropriate initiation of PPIs via the IV route was more likely to take place on the medical floor than the surgical floor (53% vs 36%, P = 0.003). The cost analysis associated with the appropriateness of the indication for PPI use as well as the route of administration of PPI revealed a possible saving of up to $17,732.5 and $14,571, respectively. CONCLUSION: This study highlights the over-utilization of IV PPIs in non-intensive care unit patients. Restriction of IV PPI use for justified indications and route of administration is recommended. |
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Authors:
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Soumana C Nasser; Jeanette G Nassif; Hani I Dimassi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: World journal of gastroenterology : WJG Volume: 16 ISSN: 1007-9327 ISO Abbreviation: World J. Gastroenterol. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-02-24 Completed Date: 2010-05-03 Revised Date: 2010-09-28 |
Medline Journal Info:
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Nlm Unique ID: 100883448 Medline TA: World J Gastroenterol Country: China |
Other Details:
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Languages: eng Pagination: 982-6 Citation Subset: IM |
Affiliation:
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Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos Campus, PO Box 36, 13-5053 Beirut, Lebanon. soumana.nasser@lau.edu.lb |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anti-Inflammatory Agents, Non-Steroidal / economics, therapeutic use Anti-Ulcer Agents* / administration & dosage, economics, therapeutic use Cost-Benefit Analysis Duodenal Ulcer* / drug therapy, economics Female Hospital Units / economics Hospitalization / economics Humans Infusions, Intravenous / economics* Male Middle Aged Omeprazole* / administration & dosage, economics, therapeutic use Prospective Studies Proton Pump Inhibitors* / administration & dosage, economics, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents, Non-Steroidal; 0/Anti-Ulcer Agents; 0/Proton Pump Inhibitors; 73590-58-6/Omeprazole |
| Comments/Corrections | |
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