Purpose: The dramatic
increase in stress ulcer prophylaxis (SUP) prescribing patterns over the past
several years has raised concerns regarding to their appropriate utilization.
This prospective study attempted to evaluate the trend of adherence to stress
ulcer prophylaxis from admission until discharge in non- Intensive care unit
(ICU) setting. Additionally, we attempted to find those variables associated
with appropriate SUP administration.
Methods: Data collection
was performed prospectively to evaluate 195 randomly selected adult patients
who received SUP or had indication for that in non-ICU wards of one of the
largest referral center in Iran, during 6 months. Adherence was studied
according to widely accepted American Society of Health system Pharmacists
(ASHP) guideline. Univariate and multivariate logistic regression was also
performed to detect associations related to misuse of SUP.
Results: We recognized
total inappropriate use of SUP upon admission, during hospital stay and at
discharge were somewhat identical at different time points (61%, 80% and 77.4%
respectively). On the other hand, since small number of patients experienced
SUP underutilization, unfortunately this was not possible to elucidate factors
that may have effect on this flawed behavior. However, increasing age was
identified to be significant variable in SUP overutilization.
This prospective study highlighted inappropriate
overutilization of SUP within non-critically ill patients and found factors
which predicted this behavior. Adherence during hospital stay was also
calculated for the first time in this study, which was related to SUP adherence
upon hospital admission.