埃塞俄比亚德布雷伯哈恩大学哈基姆·吉扎乌医院外科住院患者应激性溃疡预防用药合理性及其影响因素评估。一项基于医院的横断面研究。
Assessment of the appropriateness of stress ulcer prophylaxis use and its determinants among admitted surgical patients at Debre Berhan University Hakim Gizaw Hospital, Ethiopia. A hospital-based cross-sectional study.
作者信息
Tsige Abate Wondesen, Beyene Dessale Abate, Wondmkun Yehualashet Teshome, Endalifer Bedilu Linger, Habteweld Habtemariam Alekaw, Gebretadik Fissha Assegidew, Gebeyehu Aregahegn Adafir, Azene Belayneh Abebaw, Alamneh Misganaw Abebaw, Tesfaye Daniel Zebene, Fered Misganaw Aynalem, Girma Mandefro Teje, Mekonen Melkamu Belayneh, Dessie Tigist Yazezew, Ayele Siraye Genzeb
机构信息
Department of Pharmacy, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia.
Department of Pharmacy, College of Health Sciences, Debre Berhan Health Science College, Debre Berhan, Ethiopia.
出版信息
Front Med (Lausanne). 2024 Apr 5;11:1345144. doi: 10.3389/fmed.2024.1345144. eCollection 2024.
INTRODUCTION
Pharmacological stress ulcer prophylaxis (SUP) has been recommended for many years to reduce the risk of clinically significant upper gastrointestinal (GI) bleeding caused by stress ulcers (SUs). Stress-related ulcer bleeding in surgical patients significantly increases morbidity and mortality. Therefore, preventing stress-induced hemorrhage is the most appropriate measure for patients who are at increased risk. However, the inappropriate use of SUP has increased in recent years, and its use in Ethiopian surgical patients has not been well studied.
OBJECTIVE
The aim of this study was to assess the appropriateness of SUP use and its determinants among admitted surgical patients at Debre Berhan University Hakim Gizaw Hospital (DBUHGH), Ethiopia.
METHODS
We randomly selected 230 patients from the whole cross-sectional group of all surgical patients at DBUHGH from 1 February to 30 June 2023. The risk of stress ulcer (SU) development was assessed using the modified American Society of Health-System Pharmacists (ASHP) guidelines. For data analysis, we used SPSS version 25.
RESULTS
The mean age of study participants was 47.2 years (SD ± 20.4), and out of the total of 230, 130 (56.5%) were women. Approximately 66% of study participants took inappropriate SUP based on ASHP guidelines criteria. The most commonly used drug class for SUP was histamine-2 receptor blockers 115 (50%). Study participants who have a Charlson Comorbidity Index Score of moderate and GI bleeding have been significantly associated with the inappropriate use of SUP.
CONCLUSION
In our study, inappropriate SUP use was common in the surgical ward of DBUHGH. This may be an area that requires further and more focused working together among clinical pharmacists and medical professionals in an institution-specific SUP protocol that aids clinicians in identifying appropriate candidates for SUP medication.
引言
多年来一直推荐使用药物性应激性溃疡预防（SUP）措施，以降低应激性溃疡（SU）导致的具有临床意义的上消化道（GI）出血风险。外科患者中与应激相关的溃疡出血会显著增加发病率和死亡率。因此，对于风险增加的患者，预防应激性出血是最合适的措施。然而，近年来SUP的不当使用有所增加，其在埃塞俄比亚外科患者中的使用情况尚未得到充分研究。
目的
本研究旨在评估埃塞俄比亚德布雷伯汉大学哈基姆·吉扎乌医院（DBUHGH）住院外科患者中SUP使用的适当性及其决定因素。
方法
我们从2023年2月1日至6月30日DBUHGH所有外科患者的整个横断面组中随机选择了230名患者。使用改良的美国卫生系统药师协会（ASHP）指南评估应激性溃疡（SU）发生的风险。对于数据分析，我们使用了SPSS 25版。
结果
研究参与者的平均年龄为47.2岁（标准差±20.4），在总共230名参与者中，130名（56.5%）为女性。根据ASHP指南标准，约66%的研究参与者使用了不适当的SUP。SUP最常用的药物类别是组胺-2受体阻滞剂，有115名（50%）。Charlson合并症指数评分为中度和有胃肠道出血的研究参与者与SUP的不当使用显著相关。
结论
在我们的研究中，DBUHGH外科病房中SUP的不当使用很常见。这可能是一个需要临床药师和医学专业人员在特定机构的SUP方案中进一步且更有针对性地合作的领域，该方案有助于临床医生识别适合使用SUP药物的患者。
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