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Tsige AW, Beyene DA, Wondmkun YT, Endalifer BL, Habteweld HA, Gebretadik FA, Gebeyehu AA, Azene BA, Alamneh MA, Tesfaye DZ, Fered MA, Girma MT, Mekonen MB, Dessie TY, Ayele SG. 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. Front Med (Lausanne) 2024; 11:1345144. [PMID: 38646554 PMCID: PMC11026640 DOI: 10.3389/fmed.2024.1345144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/07/2024] [Indexed: 04/23/2024] Open
Abstract
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.
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Affiliation(s)
- Abate Wondesen Tsige
- Department of Pharmacy, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Dessale Abate Beyene
- Department of Pharmacy, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | | | - Bedilu Linger Endalifer
- Department of Pharmacy, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | | | | | - Aregahegn Adafir Gebeyehu
- Department of Pharmacy, College of Health Sciences, Debre Berhan Health Science College, Debre Berhan, Ethiopia
| | - Belayneh Abebaw Azene
- Department of Pharmacy, Debre Berhan University Hakim Gizaw Hospital, Debre Berhan, Ethiopia
| | - Misganaw Abebaw Alamneh
- Department of Pharmacy, Debre Berhan University Hakim Gizaw Hospital, Debre Berhan, Ethiopia
| | - Daniel Zebene Tesfaye
- Department of Pharmacy, Debre Berhan University Hakim Gizaw Hospital, Debre Berhan, Ethiopia
| | - Misganaw Aynalem Fered
- Department of Pharmacy, Debre Berhan University Hakim Gizaw Hospital, Debre Berhan, Ethiopia
| | - Mandefro Teje Girma
- Department of Pharmacy, Debre Berhan University Hakim Gizaw Hospital, Debre Berhan, Ethiopia
| | | | - Tigist Yazezew Dessie
- Department of Pharmacy, Debre Berhan University Hakim Gizaw Hospital, Debre Berhan, Ethiopia
| | - Siraye Genzeb Ayele
- Department of Midwifery, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Alosaily YA, Alfallaj JM, Alabduljabbar JS, Alfehaid EF, Alfayez OM, Elrasheed M. Appropriateness of proton pump inhibitors use in noncritically ill hospitalized children in a tertiary hospital in Saudi Arabia. Saudi Pharm J 2023; 31:101723. [PMID: 37608963 PMCID: PMC10440568 DOI: 10.1016/j.jsps.2023.101723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023] Open
Abstract
Background Studies assessing the appropriate use of proton pump inhibitors (PPIs) for hospitalized noncritically ill pediatric patients are lacking. Therefore, this study aimed to assess the suitability of PPI prescriptions in noncritically ill pediatric patients. Methods This cross sectional retrospective study was conducted at a maternity hospital in Qassim, Saudi Arabia from November 2020 to January 2021. All noncritically ill hospitalized children aged 14 years and below who received PPIs were included. The endpoints included the number and percentage of patients who appropriately received PPIs in general and in each age category. The collected data were analyzed using Microsoft Excel (version 2208, Microsoft Corp., Redmond, WA, USA). Results In total, 332 medical records were screened, of which 246 were included. Of all patients, 49.2% were children and 50.8% were infants, with the average age at admission being 5.39 ± 5.4 years years. More than half of the patients were female, and the average weight of patients was 19.8 kg. Omeprazole was appropriately used in 95 (38.5%) patients. Based on age groups, omeprazole was appropriately used in 66.3% of children and 38.4% of infants. Conclusion The use of omeprazole in noncritically ill pediatrics was only deemed appropriate in 38.6% of the study population. This result indicates that this medication was overused in the institution. Additional research is required to confirm this on a nationwide scale.
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Affiliation(s)
- Yousif A. Alosaily
- Pharmacy Department, Maternity and Children Hospital Buraydah, Qassim, Saudi Arabia
| | | | | | | | - Osamah M. Alfayez
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, Saudi Arabia
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Akkawi ME, Elnaem MH. Evaluation of the prescribing of proton pump inhibitors as stress ulcer prophylaxis for non-ICU patients in a Malaysian tertiary hospital. Drugs Ther Perspect 2020. [DOI: 10.1007/s40267-020-00770-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Wijaya D, Padolo E, Ardianto C, Matulatan F, Alderman CP. Analysis of the use and cost of stress ulcer prophylaxis for surgical inpatients. J Basic Clin Physiol Pharmacol 2020; 30:/j/jbcpp.ahead-of-print/jbcpp-2019-0306/jbcpp-2019-0306.xml. [PMID: 31926087 DOI: 10.1515/jbcpp-2019-0306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 11/20/2019] [Indexed: 11/15/2022]
Abstract
Background Stress ulcer is a superficial and asymptomatic lesion and causes bleeding. As many as 50% of death cases are reported as the result of stress ulcer bleeding. Stress ulcer prophylaxis (SUP) is a drug used to prevent gastrointestinal tract injuries due to stress ulcers. The inappropriate use of SUP drugs can cause adverse drug reactions, and thus SUP drugs are only given to patients in accordance with guidelines in order to avoid the overuse of SUP drugs. The aim of this present study is to analyse the suitability of SUP drug usage based on the criteria from the American Society of Health-System Pharmacists (ASHP) and the drug costs of SUP overuse. Methods An observational descriptive study was conducted from April 24, 2019, to May 17, 2019, in the inpatient surgical ward of Dr. Soetomo General Hospital. Data were obtained from patient medical health records. Results One hundred fifty-two patients used 1404 SUP drugs. Approximately 48% of usage did not suit the ASHP criteria and was considered as medication overuse. The cost of excessive SUP usage during the study period was more than US $65, which is 30.08% of the total drug cost of prescribed stress ulcer drugs. Conclusions The present study suggests that the relatively high excessive drug costs for SUP show a need for monitoring of the application of SUP therapy guidelines.
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Affiliation(s)
- Dhani Wijaya
- Master Program in Clinical Pharmacy, Faculty of Pharmacy, University of Airlangga, Surabaya, Indonesia.,Department of Pharmacy, Faculty of Medicine and Health Science, Universitas Islam Negeri Maulana Malik Ibrahim Malang, Malang, Indonesia
| | - Elfri Padolo
- Department of Pharmacy, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Chrismawan Ardianto
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Airlangga, Surabaya, Indonesia
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- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Airlangga, Surabaya, Indonesia
| | - Fendy Matulatan
- Department of General Surgery, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Christopher Paul Alderman
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Airlangga, Surabaya, Indonesia.,School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
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- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Airlangga, Surabaya, Indonesia
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