| Stress ulcer prophylaxis: reducing non-indicated prescribing after hospital discharge. | |
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MedLine Citation:
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PMID: 20841521 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Gastric acid suppressant medications used as stress ulcer prophylaxis (SUP) in the intensive care unit (ICU) are often prescribed inappropriately after discharge. We present tools to reduce the use and cost of non-indicated SUP. OBJECTIVE: To reduce the non-indicated use of SUP after hospital discharge originally started in the ICU, using an education intervention and pharmacist-led medication reconciliation on patient care rounds and at hospital discharge. METHODS: In a retrospective medical record review using a historic control, 356 consecutively admitted patients to the medical/surgical ICU at the University of Wisconsin Hospital were assessed for the appropriate use of SUP at admission to the ICU, at transfer to a general care unit, and at hospital discharge. The education intervention involved teaching both the medical and pharmacist staff about indications for SUP using a memorandum and a pocket guide. Pharmacists also conducted medication reconciliation during daily patient care rounds and at discharge to justify medication use. The outcome of this study is the percentage of patients prescribed non-indicated gastric acid suppressants at hospital discharge. This outcome is compared to a previous study conducted at our hospital. RESULTS: Of 356 eligible patients, 308 (86.5%) received SUP while in the ICU. Thirty-nine (11%) were given continuing SUP after discharge from the hospital, of which 31 (8.7%) had no clear indication. This was a 64.3% reduction from the 24.4% found in the prior study (p < 0.0001). CONCLUSIONS: Educational materials that guide prescribing, pharmacist interaction on patient care rounds, and pharmacist-conducted medication reconciliation significantly reduced the prescribing of non-indicated gastric acid suppressant medications after hospital discharge. |
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Authors:
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Jacob B Hatch; Lucas Schulz; Jeffrey T Fish |
Publication Detail:
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Type: Journal Article Date: 2010-09-14 |
Journal Detail:
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Title: The Annals of pharmacotherapy Volume: 44 ISSN: 1542-6270 ISO Abbreviation: Ann Pharmacother Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-23 Completed Date: 2011-01-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203131 Medline TA: Ann Pharmacother Country: United States |
Other Details:
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Languages: eng Pagination: 1565-71 Citation Subset: IM |
Affiliation:
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Department of Pharmacy Services, University of Wisconsin Hospital and Clinics, Madison, USA. jhatch@uwhealth.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anti-Ulcer Agents / administration & dosage, economics, therapeutic use* Continuity of Patient Care Drug Utilization Female Health Care Costs Hospitals, University Humans Inappropriate Prescribing* Intensive Care Units Male Medication Reconciliation* Middle Aged Patient Discharge* Patient Education as Topic Peptic Ulcer / economics, etiology, prevention & control* Pharmacists Pharmacy Service, Hospital Professional Role Retrospective Studies Stress, Psychological / complications, economics, prevention & control* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Ulcer Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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