Document Detail


Factors associated with inappropriate inpatient prescribing of acid-suppressive therapy.
MedLine Citation:
PMID:  20218033     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Acid-suppressive therapy is used for 54-70% of inpatients, and is frequently prescribed for inappropriate indications. The objective of this study was to identify characteristics associated with inappropriate prescribing of acid-suppressive therapy. METHODS: A random sample of adult internal medicine inpatients admitted between 1 July 2005 and 30 June 2006 was screened for acid-suppressive therapy. Patients receiving such therapy without an accepted indication and those not prescribed acid-suppressive therapy were included in group 1 and group 2, respectively. Significant characteristics from separate univariate regression models were entered into a multivariate logistic regression to determine characteristics associated with inappropriate use. The setting was internal medicine units at a tertiary care academic medical centre. KEY FINDINGS: There were 108 patients in group 1 and 134 patients in group 2. Group 1 patients were older, had a longer median length of stay, a greater number of comorbidities, a greater median number of medications upon admission, and a higher rate of cirrhosis. Factors associated with use of acid-suppressive therapy without an accepted indication were use of a proton-pump inhibitor (odds ratio, 15.3; 95% confidence interval, 4.1-56.3) or histamine2 receptor antagonist (14.5; 2.8-74.8) prior to admission, cirrhosis (6.4; 1.02-39.5), use of inpatient anticoagulants (2.7; 1.4-5.2) and length of stay (1.1; 1.1-1.3). CONCLUSIONS: The strongest factors associated with use of acid-suppressive therapy without an accepted indication were use of a proton-pump inhibitor or histamine2 receptor antagonist prior to admission, a diagnosis of cirrhosis and use of inpatient anticoagulants.
Authors:
Lindsay B Palkovic; Kim C Coley; Denise R Sokos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The International journal of pharmacy practice     Volume:  17     ISSN:  0961-7671     ISO Abbreviation:  Int J Pharm Pract     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2010-03-11     Completed Date:  2010-03-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204243     Medline TA:  Int J Pharm Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  73-5     Citation Subset:  IM    
Affiliation:
Department of Pharmacy Practice and Pharmacy Administration, University of the Sciences in Philadelphia-Philadelphia College of Pharmacy, Philadelphia, Pennsylvania 19104, USA. l.palkovic@usp.edu
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MeSH Terms
Descriptor/Qualifier:
Academic Medical Centers
Age Factors
Antacids / therapeutic use*
Anticoagulants / therapeutic use
Fibrosis / complications
Histamine H2 Antagonists / therapeutic use
Humans
Internal Medicine
Length of Stay
Logistic Models
Middle Aged
Physician's Practice Patterns / standards*
Proton Pump Inhibitors / therapeutic use
Retrospective Studies
Chemical
Reg. No./Substance:
0/Antacids; 0/Anticoagulants; 0/Histamine H2 Antagonists; 0/Proton Pump Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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