Rauch Julia, Franze Marco, Patrzyk Maciej, Heidecke Claus-Dieter, Schulze Tobias
Department of General Surgery, Visceral, Thoracic and Vascular Surgery, Universitätsmedizin Greifswald, 17475 Greifswald, Germany.
Institute of Community Medicine, Universitätsmedizin Greifswald, 17489 Greifswald, Germany.
Healthcare (Basel). 2021 Nov 2;9(11):1490. doi: 10.3390/healthcare9111490.
Despite the growing concern over its potentially severe side effects and considerable economic burden, stress ulcer prophylaxis (SUP) is still frequently prescribed to patients in medical non-intensive care units. Recent data indicate that the situation is similar in surgical departments. Currently, data on the concepts within and regulation of routine SUP practice in surgical departments are sparse. The present study was designed to examine the current practice of SUP in Mecklenburg West Pomerania, Germany, and to identify possible reasons for the dissociation of medical literature and clinical practice.
A questionnaire-based survey was conducted to elucidate current SUP practices in surgical departments of acute care hospitals in Mecklenburg Western Pomerania, Germany.
In most surgical departments (68%), a standard operating procedure (SOP) for SUP had not been developed. In departments with an existing SOP, 47.6% of responding medical staff members (MSM) with prescribing authority did not know of its existence. Of the MSMs aware of the existence of an SUP-SOP, only 42.9% indicated that they were familiar with its content. Critical re-evaluation of SUP indications upon transfer from the intensive care unit (ICU) to the general hospital ward (GHW) and before hospital discharge was performed frequently or systematically by only about half of the responding MSMs.
In the face of continued massive over-prescription of SUP in the perioperative routine, the development of easy-to-use local guidelines and their strict implementation in the clinical routine, as well as intensified medial education on this subject, may be effective tools to reduce acid-suppressive medication (ASM) associated side effects and economic burden.
尽管人们越来越关注应激性溃疡预防（SUP）潜在的严重副作用和巨大经济负担，但在非重症监护病房中，仍经常给患者开具SUP。近期数据表明，外科科室的情况类似。目前，关于外科科室常规SUP实践中的概念和规范的数据稀少。本研究旨在调查德国梅克伦堡-前波美拉尼亚州应激性溃疡预防的当前实践情况，并确定医学文献与临床实践脱节的可能原因。
通过问卷调查来阐明德国梅克伦堡-前波美拉尼亚州急症医院外科科室当前的SUP实践情况。
在大多数外科科室（68%），尚未制定SUP的标准操作规程（SOP）。在有现有SOP的科室中，47.6%有处方权的受访医务人员（MSM）不知道其存在。在知晓存在SUP-SOP的MSM中，只有42.9%表示熟悉其内容。只有约一半的受访MSM经常或系统地在从重症监护病房（ICU）转至普通医院病房（GHW）时以及出院前对应激性溃疡预防指征进行严格重新评估。
鉴于围手术期常规中SUP持续大量过度处方的情况，制定易于使用的当地指南并在临床常规中严格实施，以及加强关于该主题的医学教育，可能是减少抑酸药物（ASM）相关副作用和经济负担的有效工具。
