Ayhan Yunus Emre, Eskidemir Güneş, Koçoğlu Kınal Ayşe Gül, Aksoy Nilay
Prof. Dr. Cemil Taşcıoğlu City Hospital, Department of Clinical Pharmacy, Istanbul, Türkiye.
Gaziosmanpaşa Education and Research Hospital, Intensive Care, İstanbul, Türkiye.
J Pharm Pharm Sci. 2025 Apr 10;28:14295. doi: 10.3389/jpps.2025.14295. eCollection 2025.
This study evaluated the use of stress ulcer prophylaxis (SUP), assessed the costs associated with inappropriate use, and highlighted the impact of clinical pharmacists on improving adherence to the SUP guidelines.
A prospective, non-randomized controlled study was carried out in two intensive care units (ICUs) of a training and research hospital between 1 June 2023 and 1 December 2023. Routine care services were provided for the observation group (OG) patients. In the guideline group (GG) patients, SUP management and routine care were performed according to ASHP guidelines. The physician and clinical pharmacist jointly evaluated the patients to determine the suitability of their SUP indications. Adherence rates to ASHP guidelines and the costs associated with nonadherence were evaluated.
A total of 196 patients were included in the study: 121 in the OG and 75 in the GG. A total of 54.6% of the patients were male, and the reason for hospitalization was mainly surgery (52.6%). SUP use was higher in OG (100%) than in GG (42.6%) (p < 0.001). The indication rate according to the ASHP guidelines was significantly higher in the GG group (100%) than in the OG group (54.5%) (p < 0.001). Dosage form adherence was significantly lower in the OG (0%) than in the GG (100%) (p < 0.001). The costs associated with proton pump inhibitor use for inappropriate indications and incorrect dosage forms were $60 versus $0 (p < 0.001) and $321 versus $0 (p < 0.001) in OG and GG, respectively. Overall, cost savings of $327 were achieved in the GG group.
Inappropriate SUP use is common in the ICUs. Adequate adherence to guidelines and proactive involvement of clinical pharmacists may reduce inappropriate SUP in ICUs and the associated costs.
本研究评估应激性溃疡预防（SUP）的使用情况，评估与不当使用相关的成本，并强调临床药师对提高SUP指南依从性的影响。
2023年6月1日至2023年12月1日期间，在一家培训和研究医院的两个重症监护病房（ICU）进行了一项前瞻性、非随机对照研究。为观察组（OG）患者提供常规护理服务。在指南组（GG）患者中，根据美国卫生系统药师协会（ASHP）指南进行SUP管理和常规护理。医生和临床药师共同评估患者，以确定其SUP适应症的适用性。评估了对ASHP指南的依从率以及与不依从相关的成本。
本研究共纳入196例患者：OG组121例，GG组75例。共有54.6%的患者为男性，住院原因主要是手术（52.6%）。OG组的SUP使用率（100%）高于GG组（42.6%）（p<0.001）。GG组根据ASHP指南的适应症率（100%）显著高于OG组（54.5%）（p<0.001）。OG组的剂型依从性（0%）显著低于GG组（100%）（p<0.001）。OG组和GG组中，用于不当适应症和错误剂型的质子泵抑制剂使用成本分别为60美元对0美元（p<0.001）和321美元对0美元（p<0.001）。总体而言，GG组节省了327美元的成本。
ICU中SUP的不当使用很常见。充分遵守指南以及临床药师的积极参与可能会减少ICU中SUP的不当使用及相关成本。
