Reducing proton pump inhibitor use in a community hospital setting Brianna Qualls Parkridge Health System Residency Program - Chattanooga, TN
Background/Purpose: The well-established efficacy of proton pump inhibitors (PPIs) and their availability as over-the-counter medications have contributed to extensive overuse of these agents in the hospital and community settings. While PPIs are valuable therapy options for stress ulcer prophylaxis and treatment of several gastrointestinal disorders, inappropriate use of these agents exposes patients to potential adverse effects including Clostridium difficile-associated diarrhea, pneumonia and bone fractures. Considering the potential risks associated with inappropriate PPI therapy, decreasing the use of these agents when they are not indicated has become a priority in the hospital setting.
Methodology: This study aims to reduce PPI utilization in the hospital setting through pharmacist-led interventions and protocols. Data was collected to evaluate PPI use and appropriateness of indication for use among patients prescribed pantoprazole. Patients who received pantoprazole from October to December 2017 were identified using VigiLanz Monitoring System and assessed via review of the electronic medical record. Patient age, sex and duration of PPI therapy were also assessed. _x000D_ Interventions to reduce PPI utilization include removal of pantoprazole from hospital order sets and education to nursing staff and physicians. Education will consist of evidence-based recommendations regarding appropriate indications of PPI use for stress ulcer prophylaxis and facility protocols for discontinuation of therapy. Patient data and PPI use collected prior to the study interventions will be compared to data collected after the inventions to evaluate the primary outcome, a reduction in PPI utilization. A secondary analysis will compare the rate of Clostridium difficile-associated diarrhea among patients receiving PPI therapy before and after the study interventions.
Presentation Objective: Assess the impact of pharmacist-led interventions to reduce proton pump inhibitor use in the institutional setting.
Self-Assessment: How do pharmacist-led interventions impact the inappropriate use of proton pump inhibitors in the institutional setting?
