Compliance with guidelines for stress ulcer prophylaxis in surgical and orthopedic units at ramathibodi hospital

Abstract

© 2018, Medical Association of Thailand. All rights reserved. Objective: Evaluate the appropriateness of proton-pump inhibitors [PPIs] use for stress-related mucosal disease [SRMD] prophylaxis in surgical and orthopedics units. Materials and Methods: A retrospective chart review study was conducted among patients admitted to the surgical and orthopedic units and received PPIs during their hospitalization at Ramathibodi Hospital between August 30, 2016 and January 18, 2017. Demographic data, medical history, and pertinent laboratory tests were obtained from medical records. Available practice guidelines and related clinical studies were utilized as references for assessing appropriateness of PPIs use. Prescribing PPIs not according to the guideline is marked as inappropriate or improper. Results: Of the 105 patients included in the present study, 58 patients (55.24%) were started on PPIs without indication as stated in the guideline. Twenty-four patients (22.86%) were continued on PPIs during hospitalization while their risk factors for SRMD was resolved. Twelve patients (11.43%) received PPIs dose inconsistent with the guideline, particularly too-high dose. Upon discharge, 37 patients (35.24%) continued to receive PPIs without proper indication. Conclusion: Improper use of PPI was common in surgical and orthopedics units. Monitoring for PPIs use is required to ensure appropriate SRMD prophylaxis.