Overuse of Acid-Suppressive Therapy in Hospitalized Patients.
Nardino, Robert J MD 1,2; Vender, Ronald J MD, FACG 1,3,2; Herbert, Peter N MD 4,2
[Article]
American Journal of Gastroenterology.
95(11):3118-3122, November 2000.
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OBJECTIVES: The aims of this study were 1) to determine the frequency of use and indications for prescription of acid-suppressive medications in hospitalized patients, and 2) to determine whether patients who are prescribed these medications for stress ulcer prophylaxis are prescribed them on hospital discharge.
METHODS: The use of acid-suppressive medications (histamine-2 receptor antagonists, proton pump inhibitors, and barriers-specifically, famotidine, omeprazole, and sucralfate) was assessed in 226 patients admitted consecutively to a general medical nursing unit of an urban, community, teaching hospital. Chart review was undertaken to determine the type of medication used, timing of prescription, and indication for use.
RESULTS: Of hospitalized patients, 54% were receiving acid-suppressive therapy. Histamine-2 receptor antagonists were used most frequently (62%). In all, 65% of prescriptions were not indicated as determined by consensus review. Among patients put on acid-suppressive therapy for ulcer prophylaxis, 55% were discharged on the therapy.
CONCLUSIONS: There is significant overuse of acid-suppressive therapy in hospitalized patients. The problem of placing low-risk patients on ulcer prophylaxis unnecessarily is compounded by discharging these patients with the medication.
(C) The American College of Gastroenterology 2000. All Rights Reserved.