Impact of a clinical pharmacist-led stewardship program for the appropriate use of acid suppression therapy in older hospitalized patients: a non-randomized controlled study.


Dumlu H. I., Sancar M., Ozdemir A., Okuyan B.

International journal of clinical pharmacy, cilt.44, sa.4, ss.914-921, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 44 Sayı: 4
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1007/s11096-022-01394-8
  • Dergi Adı: International journal of clinical pharmacy
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Agricultural & Environmental Science Database, CAB Abstracts, CINAHL, EMBASE, Index Islamicus, MEDLINE
  • Sayfa Sayıları: ss.914-921
  • Anahtar Kelimeler: Proton pump inhibitor, Geriatric, Medication review, Potentially inappropriate medication, PROTON PUMP INHIBITORS, STRESS-ULCER PROPHYLAXIS, IMPROVE, DISEASE
  • Marmara Üniversitesi Adresli: Evet

Özet

Background The potentially inappropriate use of the proton pump inhibitors is prevalent in older adults. Aim To evaluate the impact of a clinical pharmacist-led stewardship program for the appropriate use of acid suppression therapy in older hospitalized patients. Method This parallel nonrandomized controlled study was conducted at an internal medicine service of a tertiary training and research hospital between September 2019 and August 2021. Older patients (>= 65 years old and received proton pump inhibitors within 48 h of admission) were allocated to two groups according to their number of medical file records, whether odd or even, two groups: control and clinical pharmacist-led stewardship program for the appropriate use of acid suppression therapy (including medication reconciliation and medication review) during the hospital stay. Primary outcome measures were the rate of appropriate use of proton pump inhibitors during hospitalization and potentially inappropriate proton pump inhibitor use at discharge. Results The rate of appropriate proton pump inhibitor use during hospitalization was significantly higher in the clinical pharmacist-led program (n = 100) than in the control group (n = 97) (46.4% vs. 79.0%; P < 0.001). The rate of potentially inappropriate proton pump inhibitor use at discharge was significantly lower (61.7% vs. 35.1%; P < 0.05) in the clinical pharmacist-led program among the older patients discharged with a proton pump inhibitor prescription. Conclusions A clinical pharmacist-led stewardship program for the appropriate use of acid suppression therapy improved the rate of appropriate proton pump inhibitor use and reduced the potentially inappropriate proton pump inhibitor use during the hospital stay.