title: Long-term use of acid suppression started inappropriately during hospitalization.
abstract: BACKGROUND
  Practitioners routinely misuse acid suppression medications on general medical floors and inappropriately continue the drug at discharge.
  
  
  OBJECTIVE
  To: (i) retrospectively study the appropriateness of acid suppression use on the general medical floors; (ii) characterize the patient population discharged on unnecessary acid suppression and (iii) evaluate whether patients discharged on unnecessary acid suppression continue the medicine long term.
  
  
  METHODS
  Retrospective chart review of general medical patients admitted to an in-patient teaching service over 6 consecutive months.
  
  
  RESULTS
  About 60% of patients lacked an indication for initiation of acid suppression and 34% of these patients were discharged on the medicine. The only independent predictor of continuation of acid suppression at discharge was longer length of stay. Multivariate analysis did not identify a characteristic distinguishing those patients discharged inappropriately on acid suppression. At 3 and 6 months of follow-up, 80% and 50% of patients, respectively, remained on acid suppression therapy without an appropriate indication.
  
  
  CONCLUSIONS
  Our data verifies that practitioners routinely start general medical in-patients on acid suppression without an appropriate indication. Many of these prescriptions are continued at discharge for no apparent reason, leading to their long-term misuse.
authors.affiliation: Division of Gastroenterology and Hepatology, William Beaumont Hospital, Royal Oak, MI 48073, USA. dzink@beaumont.edu
authors.forename: D A
authors.initials: DA
authors.lastname: Zink
authors.forename: M
authors.initials: M
authors.lastname: Pohlman
authors.forename: M
authors.initials: M
authors.lastname: Barnes
authors.forename: M E
authors.initials: ME
authors.lastname: Cannon
mesh_terms: D000368:Aged; D000863:Antacids / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D011307:Drug Prescriptions / Q000592:standards; D017723:Drug Utilization Review; D005500:Follow-Up Studies; D006300:Health Services Misuse; D006784:Hospitals, Teaching / Q000592:standards*; D006801:Humans; D007902:Length of Stay; D008824:Michigan; D008875:Middle Aged; D010351:Patient Discharge / Q000592:standards*; D012189:Retrospective Studies; D012646:Self Administration
chemical_list: D000863:Antacids