Decrease Utilization of Proton Pump Inhibitors

Decrease utilization of Proton Pump Inhibitors by 10%

The use of acid-suppressive medication in hospitalized patients has increased significantly over the last several decades. Studies estimate that 40 to 70 percent of medical inpatients receive acid-suppressive medications during their hospitalization. Although some of these patients have clear indications for acid-suppression, research has consistently found that the vast majority do not. This practice appears to have stemmed from the use of acid-suppression to prevent stress-related gastrointestinal bleeding in critically ill patients, where the incidence of hospital acquired gastrointestinal bleeding and the effect of acid-suppressive medication have been well characterized. In addition to the financial cost incurred by this practice, several recent studies have demonstrated increased risks of infection associated with use of acid-suppressive medication in hospitalized patients, including Clostridium difficile infection and hospital-acquired pneumonia.

The primary acid suppression therapy employed within the health system are the Proton Pump Inhibitors (PPI)s. The Acute Care Service Line developed criteria based on The American Society of Health-System Pharmacists stress ulcer prophylaxis guidelines. Letters were sent to all clinicians with appropriate guideline criteria. Pharmacist interventions in consultation with clinicians resulted in a 20 % decrease in the use of PPIs through the Health System.

PPI Decrease

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