Impact of pharmacy intervention on the use of proton-pump inhibitors in the hospital setting.

OBJECTIVE

Determine effectiveness of pharmacy-driven medical staff training regarding proton-pump inhibitor (PPI) therapy.

DESIGN

This study was performed in two parts. Part I evaluated baseline PPI usage within the hospital. Part II evaluated the effect of pharmacy-driven medical staff education on PPI prescribing patterns. Data were collected retrospectively via electronic chart review.

SETTING

Passavant Area Hospital in Jacksonville, Illinois, is a 99-bed community hospital.

PARTICIPANTS

Patients' profiles were selected if administration of at least one PPI was electronically charted during their hospital stay. Patients discharged from the emergency department were not included in the study. There were a total of 1,089 charts reviewed (Part I: N=565; Part II: N=524). The average patient age was 66.5 years.

INTERVENTIONS

Part I results were presented to the pharmacy and therapeutics (P&T) committee and medical staff. A series of three educational presentations were subsequently given to medical staff. Part II results were reported to the P&T committee, with further interventions to be determined after consulting with hospital administration and medical staff.

MAIN OUTCOME MEASURE

Improvement of appropriate acute PPI therapy. Secondary outcome measures included duration of acute therapy and continuation of chronic therapy.

RESULTS

There was improvement in the appropriate usage of PPI for stress ulcer prophylaxis (SUP) (P=0.1216), decreased chronic PPI therapy (P=0.0054), and increased documentation of PPI indication (P=0.0365). A decrease of appropriate acute duration of PPI for SUP was also observed (P<0.0001).

CONCLUSIONS

Appropriate initiation of acute and continuation of chronic PPI therapies improved. Appropriate duration of use declined in SUP patients. Pharmacy interventions have an overall positive impact on appropriate use of PPI therapy.