Overuse of acid suppression therapy in hospitalized patients.
BACKGROUND
Acid suppression therapy (AST) is one of the most commonly prescribed classes of medications in hospitalized patients. Multiple studies have shown that AST is overused during inpatient admissions. However, minimal data is available regarding the frequency and patient characteristics of those discharged on unnecessary AST. The aims of the study were to examine administration of AST on admission, to characterize the patient population discharged on unnecessary AST and to determine predictive factors for inappropriate administration of AST in hospitalized patients.


METHODS
A retrospective chart review of randomly selected patients admitted to the general medicine service at University of Florida Health Science Center/Jacksonville from August to October 2006 for appropriateness of AST was done. The admitting diagnosis, indications for starting AST, type of AST used, and discharge on these medications was recorded on a case by case basis.


RESULTS
Seventy percent of patients were started on AST on admission. Of these, 73% were unnecessary. Stress ulcers prophylaxis in low risk patients or the concomitant use of ulcerogenic drugs motivated initiation of therapy most frequently. Sixty nine percent of patients started on inappropriate AST were discharged on the same regimen. Admitting diagnosis, age of patient, length of stay, or concomitant use of ulcerogenic drugs did not predict continuation of unnecessary AST at discharge.


CONCLUSIONS
AST is overused in hospitalized patients. This primarily occurred in low risk patients and was compounded by continuation at discharge. This significantly increases cost to the health care system and the risk of drug interactions.
Department of Medicine and Division of Gastroenterology, University of Florida College of Medicine Center/Jacksonville, Jacksonville, FL, USA.
Ruchi
R
Gupta
Praveen
P
Garg
Ravi
R
Kottoor
Juan Carlos
JC
Munoz
M Mazen
MM
Jamal
Louis R
LR
Lambiase
Kenneth J
KJ
Vega
D000046:Academic Medical Centers; D000863:Antacids / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D004363:Drug Utilization; D005260:Female; D005431:Florida; D006801:Humans; D007297:Inpatients; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010351:Patient Discharge; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*
D000863:Antacids; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors