Nardino R J, Vender R J, Herbert P N
Department of Medicine, Hospital of Saint Raphael, New Haven, Connecticut 06511, USA.
Am J Gastroenterol. 2000 Nov;95(11):3118-22. doi: 10.1111/j.1572-0241.2000.03259.x.
The aims of this study were 1) to determine the frequency of use and indications for prescription of acid-suppressive medications in hospitalized patients, and 2) to determine whether patients who are prescribed these medications for stress ulcer prophylaxis are prescribed them on hospital discharge.
The use of acid-suppressive medications (histamine-2 receptor antagonists, proton pump inhibitors, and barriers--specifically, famotidine, omeprazole, and sucralfate) was assessed in 226 patients admitted consecutively to a general medical nursing unit of an urban, community, teaching hospital. Chart review was undertaken to determine the type of medication used, timing of prescription, and indication for use.
Of hospitalized patients, 54% were receiving acid-suppressive therapy. Histamine-2 receptor antagonists were used most frequently (62%). In all, 65% of prescriptions were not indicated as determined by consensus review. Among patients put on acid-suppressive therapy for ulcer prophylaxis, 55% were discharged on the therapy.
There is significant overuse of acid-suppressive therapy in hospitalized patients. The problem of placing low-risk patients on ulcer prophylaxis unnecessarily is compounded by discharging these patients with the medication.
本研究的目的是：1）确定住院患者使用抑酸药物的频率及处方指征；2）确定因预防应激性溃疡而开具这些药物的患者在出院时是否仍在使用该药物。
对一家城市社区教学医院普通内科护理单元连续收治的226例患者使用抑酸药物（组胺-2受体拮抗剂、质子泵抑制剂和黏膜保护剂——具体为法莫替丁、奥美拉唑和硫糖铝）的情况进行评估。通过查阅病历确定所用药物的类型、处方时间和使用指征。
住院患者中，54%正在接受抑酸治疗。组胺-2受体拮抗剂使用最为频繁（62%）。经共识审查确定，所有处方中有65%无用药指征。在因预防溃疡而接受抑酸治疗的患者中，55%出院时仍在接受该治疗。
住院患者中存在明显过度使用抑酸治疗的情况。让低风险患者不必要地接受溃疡预防治疗，且出院时仍带药的问题更为严重。
