| Factors associated with inappropriate inpatient prescribing of acid-suppressive therapy. | |
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MedLine Citation:
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PMID: 20218033 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Lindsay B Palkovic; Kim C Coley; Denise R Sokos |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The International journal of pharmacy practice Volume: 17 ISSN: 0961-7671 ISO Abbreviation: Int J Pharm Pract Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2010-03-11 Completed Date: 2010-03-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9204243 Medline TA: Int J Pharm Pract Country: England |
Other Details:
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Languages: eng Pagination: 73-5 Citation Subset: IM |
Affiliation:
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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 |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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