Adherence to stress-related mucosal damage prophylaxis guideline in patients admitted to the Intensive Care Unit

Objective: Concern about adverse effects of the inconsistent use of stress-related mucosal damage prophylaxis in intensive care unit (ICU) is increasing. Hence, this study was designed to prospectively evaluate the rate of inappropriate stress ulcer prophylaxis (SUP) administration upon ICU admissio...

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Main Authors: Niloofar Rafinazari, Saeed Abbasi, Shadi Farsaei, Marjan Mansourian, Peyman Adibi
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2016-01-01
Series:Journal of Research in Pharmacy Practice
Subjects:
Online Access:http://www.jrpp.net/article.asp?issn=2319-9644;year=2016;volume=5;issue=3;spage=186;epage=192;aulast=Rafinazari
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author Niloofar Rafinazari
Saeed Abbasi
Shadi Farsaei
Marjan Mansourian
Peyman Adibi
author_facet Niloofar Rafinazari
Saeed Abbasi
Shadi Farsaei
Marjan Mansourian
Peyman Adibi
author_sort Niloofar Rafinazari
collection DOAJ
description Objective: Concern about adverse effects of the inconsistent use of stress-related mucosal damage prophylaxis in intensive care unit (ICU) is increasing. Hence, this study was designed to prospectively evaluate the rate of inappropriate stress ulcer prophylaxis (SUP) administration upon ICU admission, at ICU discharge and determine the adherence to American Society of Health-System Pharmacists (ASHP) guideline during ICU stay. Methods: In this study, 200 patients were randomly selected from all ICU admissions during 9 months. Risk factors of stress ulcer were recorded daily during ICU stay and appropriateness of SUP administration was assessed according to the ASHP criteria. Findings: Of all 160 (80%) patients who received SUP, 44.4% did not have indication; and among 95 patients with an indication for SUP administration, 6.3% did not receive it upon ICU admission. Consequently, 77 (38.5%) of 200 patients received inappropriate prophylaxis on ICU admission. In addition, 53.5% of patients had appropriate adherence to ASHP guideline during all days of ICU stay (44% and 2.5% of patients received SUP more than 120% and <80% of appropriate SUP duration, respectively). Moreover, 81.2% were continued on inappropriate prophylaxis upon transfer from the ICU. Conclusion: We concluded that although SUP administration included both overutilization and underutilization in this ICU, but high prevalence of SUP overutilization caused unnecessary hospital costs, personal monetary burden, and may increase adverse drug reactions. Therefore, educating physicians and cooperation of clinical pharmacists regarding implementing standard protocols could improve patterns of SUP administration.
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spelling doaj.art-2b78a5ff26d34f3696f06640dfa03ce22022-12-21T19:46:55ZengWolters Kluwer Medknow PublicationsJournal of Research in Pharmacy Practice2319-96442279-042X2016-01-015318619210.4103/2279-042X.185728Adherence to stress-related mucosal damage prophylaxis guideline in patients admitted to the Intensive Care UnitNiloofar RafinazariSaeed AbbasiShadi FarsaeiMarjan MansourianPeyman AdibiObjective: Concern about adverse effects of the inconsistent use of stress-related mucosal damage prophylaxis in intensive care unit (ICU) is increasing. Hence, this study was designed to prospectively evaluate the rate of inappropriate stress ulcer prophylaxis (SUP) administration upon ICU admission, at ICU discharge and determine the adherence to American Society of Health-System Pharmacists (ASHP) guideline during ICU stay. Methods: In this study, 200 patients were randomly selected from all ICU admissions during 9 months. Risk factors of stress ulcer were recorded daily during ICU stay and appropriateness of SUP administration was assessed according to the ASHP criteria. Findings: Of all 160 (80%) patients who received SUP, 44.4% did not have indication; and among 95 patients with an indication for SUP administration, 6.3% did not receive it upon ICU admission. Consequently, 77 (38.5%) of 200 patients received inappropriate prophylaxis on ICU admission. In addition, 53.5% of patients had appropriate adherence to ASHP guideline during all days of ICU stay (44% and 2.5% of patients received SUP more than 120% and <80% of appropriate SUP duration, respectively). Moreover, 81.2% were continued on inappropriate prophylaxis upon transfer from the ICU. Conclusion: We concluded that although SUP administration included both overutilization and underutilization in this ICU, but high prevalence of SUP overutilization caused unnecessary hospital costs, personal monetary burden, and may increase adverse drug reactions. Therefore, educating physicians and cooperation of clinical pharmacists regarding implementing standard protocols could improve patterns of SUP administration.http://www.jrpp.net/article.asp?issn=2319-9644;year=2016;volume=5;issue=3;spage=186;epage=192;aulast=RafinazariIntensive Care Unit; stress ulcer prophylaxis; stress-related mucosal damage
spellingShingle Niloofar Rafinazari
Saeed Abbasi
Shadi Farsaei
Marjan Mansourian
Peyman Adibi
Adherence to stress-related mucosal damage prophylaxis guideline in patients admitted to the Intensive Care Unit
Journal of Research in Pharmacy Practice
Intensive Care Unit; stress ulcer prophylaxis; stress-related mucosal damage
title Adherence to stress-related mucosal damage prophylaxis guideline in patients admitted to the Intensive Care Unit
title_full Adherence to stress-related mucosal damage prophylaxis guideline in patients admitted to the Intensive Care Unit
title_fullStr Adherence to stress-related mucosal damage prophylaxis guideline in patients admitted to the Intensive Care Unit
title_full_unstemmed Adherence to stress-related mucosal damage prophylaxis guideline in patients admitted to the Intensive Care Unit
title_short Adherence to stress-related mucosal damage prophylaxis guideline in patients admitted to the Intensive Care Unit
title_sort adherence to stress related mucosal damage prophylaxis guideline in patients admitted to the intensive care unit
topic Intensive Care Unit; stress ulcer prophylaxis; stress-related mucosal damage
url http://www.jrpp.net/article.asp?issn=2319-9644;year=2016;volume=5;issue=3;spage=186;epage=192;aulast=Rafinazari
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