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Long-term use of acid suppression started inappropriately during hospitalization
D A Zink1, M Pohlman, M Barnes
1Division of Gastroenterology and Hepatology, William Beaumont Hospital, Royal Oak, MI 48073, USA. dzink@beaumont.edu
Background:
Practitioners routinely misuse acid suppression medications on general medical floors and inappropriately continue the drug at discharge.
Aims:
To: (i) retrospectively study the appropriateness of acid suppression use on the general medical floors; (ii) characterize the patient population discharged on unnecessary acid suppression and (iii) evaluate whether patients discharged on unnecessary acid suppression continue the medicine long term.
Methods:
Retrospective chart review of general medical patients admitted to an in-patient teaching service over 6 consecutive months.
Results:
About 60% of patients lacked an indication for initiation of acid suppression and 34% of these patients were discharged on the medicine. The only independent predictor of continuation of acid suppression at discharge was longer length of stay. Multivariate analysis did not identify a characteristic distinguishing those patients discharged inappropriately on acid suppression. At 3 and 6 months of follow-up, 80% and 50% of patients, respectively, remained on acid suppression therapy without an appropriate indication.
Conclusions:
Our data verifies that practitioners routinely start general medical in-patients on acid suppression without an appropriate indication. Many of these prescriptions are continued at discharge for no apparent reason, leading to their long-term misuse.
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