A Study of Rational Prescribing of Proton Pump Inhibitor’s in Sina Hospital of Tabriz

Abstract

To evaluate the current practice of stress ulcer prophylaxis and Calculation of additional costs incurred due to irrational administration of PPIs in stress ulcer prophylaxis (SUP) at sina hospital in tabriz.

Methods

A multi-part prospective review study was conducted over 6 mo. A questionnaire was was set up to collected data on demographics, SUP medications, dose, route, and associated risk factors. The appropriateness of SUP use was determined as per American Society of Health-System Pharmacists guidelines. Clinical pharmacist approval was obtained from sina hospital and extra costs were calculated using the information collected in the questionnaire.

Results

A total of 264 patients were included. 40.5% of the patients who received prophylaxis did not have an indication for SUP. The majority (71.6%) of the patients who were administered parenteral drugs can tolerate oral medications. Overall, the regimen of acid-suppressant drugs was suboptimal in 87.6% ofthe sample. Of 157 patients that have an indication for SUP; 59 (37/57%) patients were administered the drug parenterally, of which 44 (74/57%) patients were able to tolerate the oral route. Although 73/86% of the patients received the appropriate dose, overall, only 39 % of the sample population was candidate for SUP and was administered the acid-suppressive regimen (dose and route) appropriately. Appropriate dosing was observed in 75.1% of the candidates for SUP and in 71.9% of the patients who did not have a justified indication for SUP. The exigent amount of money for hospital would equal 276206000 rials, which is just because of the unreasonably prescribing of injections instead of edible forms.

Conclusion

This study highlighted the need, in sina hospital at tabriz, to establish clinical practice guidelines for the use of SUP; mainly in critical care settings