Impact of a Clinical Pharmacist Stress Ulcer Prophylaxis Management Program on Inappropriate Use in Hospitalized Patients.
Am J Med. 2015 Mar 26;
Authors: Buckley MS, Park AS, Anderson CS, Barletta JF, Bikin DS, Gerkin RD, O'Malley CW, Wicks LM, Garcia-Orr R, Kane-Gill SL
PURPOSE: Appropriate utilization of stress ulcer prophylaxis should be limited to high-risk, intensive care unit (ICU) patients. However, inappropriate stress ulcer prophylaxis use among all hospitalized patients remains a concern. The purpose of this study was to evaluate the clinical and economic impact of a novel pharmacist-managed stress ulcer prophylaxis program in ICU and general ward patients.
METHODS: This retrospective, pre- and-post study design was conducted in adult ICU and general ward patients at a large academic medical center between January 1, 2011, and January 31, 2012 to compare the rates of inappropriate stress ulcer prophylaxis before and after the implementation of a pharmacist-led stress ulcer prophylaxis management program.
RESULTS: A total of 1,134 unique patients consisting of 16,415 patient-days were evaluated. The relative reduction in the rate of inappropriate stress ulcer prophylaxis days after program implementation in ICU and general ward patients was 58.3% and 83.5%, respectively (p<0.001). The rate of ICU patients inappropriately continued on stress ulcer prophylaxis upon hospital discharge in the pre- and post-groups were 29.9% and 3.6%, respectively (p<0.001), while general ward patients significantly decreased from 36.2% to 5.4% in the pre- and post-groups, respectively (p<0.001). Total inpatient costs associated with all stress ulcer prophylaxis administered was $20,052.70 in the pre- and $3,280.49 in the post-implementation group (p<0.001) resulting in an estimated cost-savings of >$200,000 annually. No differences in clinical outcomes were observed.
CONCLUSIONS: The implementation of a pharmacist-managed stress ulcer prophylaxis program was associated with a decrease in inappropriate acid suppression rates during hospitalization and upon discharge as well as and significant costs-savings.
PMID: 25820164 [PubMed - as supplied by publisher]