title: Correlates and economic outcomes of proton pump inhibitor use by routes in intensive care unit patients.
abstract: Objectives were to evaluate correlates, and economic outcomes of proton pump inhibitor (PPI) use by route in the intensive care unit from an institutional-payer perspective. A 13-month retrospective study of electronic medical records was conducted of 534 adult (≥19 year-old) intensive care unit patients receiving a PPI (39% enteral-only, 34% parenteral-only, 27% both-route) in a Midwest USA academic medical center. Possible cost-savings with sensitivity analysis were estimated as differences in drug costs (US dollars) between switch eligible parenteral and alternate enteral-PPI medication doses. In multivariate logistic-regression of switch criteria (any oral-medication, orogastric-tube, nothing by oral route), significant correlate for enteral versus parenteral PPI-use was any oral-medication use but not orogastric-tube. Using enteral esomeprazole/lansoprazole instead of parenteral (esomeprazole/pantoprazole) PPI (in 37% i.e. 696 of 1895 switch-eligible doses) would have saved US$2384.17 or US$3564.86, respectively. By switching eligible patients on oral-medications or on orogastric-tube from parenteral- to enteral-PPI, institutions can realize significant drug cost-savings.
authors: Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE, USA.
authors: Jayashri
authors: J
authors: Sankaranarayanan
authors: Tom
authors: T
authors: Reardon
authors: Keith M
authors: KM
authors: Olsen
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D057286:Electronic Health Records; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007362:Intensive Care Units / Q000191:economics*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D018803:Models, Economic; D015999:Multivariate Analysis; D054328:Proton Pump Inhibitors / Q000008:administration & dosage* / Q000191:economics*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors
keywords: acid suppressive agent; correlates; drug cost saving; intensive care; intravenous to oral switch