Impact of targeted educational interventions on appropriateness of stress ulcer prophylaxis in critically ill adults

Background: Acid suppression therapy (AST) is routinely used in critically ill patients to prevent stress-related mucosal bleeding (SRMB). Objective: Our objective was to determine the impact of a structured educational intervention on AST used for prevention of SRMB on appropriateness of AST. Me...

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Main Authors: Hammond DA, Killingsworth CA, Painter JT, Pennick RE, Chatterjee K, Boye B, Meena N
Format: Article
Language:English
Published: Centro de Investigaciones y Publicaciones Farmaceuticas 2017-09-01
Series:Pharmacy Practice
Subjects:
Online Access:https://www.pharmacypractice.org/journal/index.php/pp/article/view/948/520
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author Hammond DA
Killingsworth CA
Painter JT
Pennick RE
Chatterjee K
Boye B
Meena N
author_facet Hammond DA
Killingsworth CA
Painter JT
Pennick RE
Chatterjee K
Boye B
Meena N
author_sort Hammond DA
collection DOAJ
description Background: Acid suppression therapy (AST) is routinely used in critically ill patients to prevent stress-related mucosal bleeding (SRMB). Objective: Our objective was to determine the impact of a structured educational intervention on AST used for prevention of SRMB on appropriateness of AST. Methods: A single-center, retrospective, cohort study of appropriate use of AST in critically ill patients admitted to the medical intensive care unit (ICU) at an academic medical center between January to June of 2014 (no intervention) and January to June of 2015 (intervention) was conducted. The percentage of patients prescribed inappropriate AST, inappropriate AST at ICU transfer and hospital discharge, doses of inappropriate AST, and adverse effects associated with AST use were compared between periods using chi-square tests. Results: Patients in the intervention group (n=118) were 5 years older than patients in the no intervention group (n=101). AST was inappropriately initiated more frequently in the no intervention group (23% vs. 11%, p=0.012). Continuation of inappropriate AST at ICU transfer and hospital discharge was similar between groups (60% vs. 53%, p=0.277 and 18% vs. 14%, p=0.368, respectively). Conclusion: Patients had appropriate AST initiated and inappropriate AST withheld more frequently when formal education was provided. This low-cost intervention strategy can be implemented easily at institutions where pharmacists interact with physicians on rounding services and should be evaluated in institutions where interactions between pharmacists and physicians occur more frequently in non-rounding situations.
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spelling doaj.art-756798a3f9fa4b3e97140455ea33f8e42022-12-21T17:51:12ZengCentro de Investigaciones y Publicaciones FarmaceuticasPharmacy Practice1885-642X1886-36552017-09-0115394894810.18549/PharmPract.2017.03.948Impact of targeted educational interventions on appropriateness of stress ulcer prophylaxis in critically ill adultsHammond DAKillingsworth CAPainter JTPennick REChatterjee KBoye BMeena NBackground: Acid suppression therapy (AST) is routinely used in critically ill patients to prevent stress-related mucosal bleeding (SRMB). Objective: Our objective was to determine the impact of a structured educational intervention on AST used for prevention of SRMB on appropriateness of AST. Methods: A single-center, retrospective, cohort study of appropriate use of AST in critically ill patients admitted to the medical intensive care unit (ICU) at an academic medical center between January to June of 2014 (no intervention) and January to June of 2015 (intervention) was conducted. The percentage of patients prescribed inappropriate AST, inappropriate AST at ICU transfer and hospital discharge, doses of inappropriate AST, and adverse effects associated with AST use were compared between periods using chi-square tests. Results: Patients in the intervention group (n=118) were 5 years older than patients in the no intervention group (n=101). AST was inappropriately initiated more frequently in the no intervention group (23% vs. 11%, p=0.012). Continuation of inappropriate AST at ICU transfer and hospital discharge was similar between groups (60% vs. 53%, p=0.277 and 18% vs. 14%, p=0.368, respectively). Conclusion: Patients had appropriate AST initiated and inappropriate AST withheld more frequently when formal education was provided. This low-cost intervention strategy can be implemented easily at institutions where pharmacists interact with physicians on rounding services and should be evaluated in institutions where interactions between pharmacists and physicians occur more frequently in non-rounding situations.https://www.pharmacypractice.org/journal/index.php/pp/article/view/948/520Anti-Ulcer AgentsInappropriate PrescribingIntensive Care UnitsPharmacistsAcademic Medical CentersRetrospective StudiesUnited States
spellingShingle Hammond DA
Killingsworth CA
Painter JT
Pennick RE
Chatterjee K
Boye B
Meena N
Impact of targeted educational interventions on appropriateness of stress ulcer prophylaxis in critically ill adults
Pharmacy Practice
Anti-Ulcer Agents
Inappropriate Prescribing
Intensive Care Units
Pharmacists
Academic Medical Centers
Retrospective Studies
United States
title Impact of targeted educational interventions on appropriateness of stress ulcer prophylaxis in critically ill adults
title_full Impact of targeted educational interventions on appropriateness of stress ulcer prophylaxis in critically ill adults
title_fullStr Impact of targeted educational interventions on appropriateness of stress ulcer prophylaxis in critically ill adults
title_full_unstemmed Impact of targeted educational interventions on appropriateness of stress ulcer prophylaxis in critically ill adults
title_short Impact of targeted educational interventions on appropriateness of stress ulcer prophylaxis in critically ill adults
title_sort impact of targeted educational interventions on appropriateness of stress ulcer prophylaxis in critically ill adults
topic Anti-Ulcer Agents
Inappropriate Prescribing
Intensive Care Units
Pharmacists
Academic Medical Centers
Retrospective Studies
United States
url https://www.pharmacypractice.org/journal/index.php/pp/article/view/948/520
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