Related Experiment Video
Updated: May 20, 2025
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Implementation of Guideline-Based Use of Proton Pump Inhibitors for Perioperative Stress Ulcer Prophylaxis: A
Xinrui Wang1, Ying Liu1, Yi Zhang1
1Department of Pharmacy, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China.
Background:
The overuse and misuse of proton pump inhibitors (PPIs) in perioperative patients for stress ulcers prophylactic (SUP) is crucial. This study evaluated the impact of a Consolidated Framework for Implementation Research Expert Recommendations for Implementing Change (CFIR-ERIC)-guided intervention on the rational use of PPIs in a perioperative setting.
Methods:
A single-center pre-post study was conducted at Beijing Chaoyang Hospital between April and November 2023. All hospitalized patients who used perioperative PPIs for SUP were included. Cases post-intervention were defined as the intervention group and were propensity score-matched with pre-intervention cases, which was defined as the control group. The intervention strategies were developed by following the updated CFIR framework and employing CFIR-ERIC strategies. Outcomes included rational use of PPIs, reasons for irrational use, total hospitalization and drug costs, PPI duration, costs, and average defined daily dose.
Results:
1122 cases were included in the intervention group and control group after propensity score matching, respectively. The intervention group showed significant improved rate of rational PPI use (81.7% vs 42.0%, p<0.001). Rates of non-indication use, inappropriate dosage and administration, drug selection, and administration route were significantly reduced (all p<0.05). Coagulation disorders or anticoagulant/antiplatelet treatment, severe trauma or multiple injuries, severe infection or sepsis were the three most prevalent severe risk factors among patients, with 46.7% and 29.5% of the two groups, respectively. We found no significant differences between the two groups in total hospitalization costs (¥55,672.84 vs ¥57,021.73, p=0.621) and total drug costs (¥3005.38 vs ¥3260.98, p=0.206). Additionally, PPI costs (¥7.44 vs ¥93.70, p<0.001) and defined daily dose (7.00 vs 8.00, p<0.001) were significantly lower in the intervention group. We also observed a downward trend in PPI duration (6.00 days vs 5.00 days, p=0.075).
Conclusion:
The CFIR-ERIC-guided intervention effectively improved the rational use of PPIs for perioperative SUP, resulting in significant reductions in both the PPI duration and costs.
More Related Videos
05:50Author Spotlight: Point-of-Care Ultrasound for Gastric Content Assessment and Risk Stratification in Perioperative Care
Published on: September 22, 2023
05:32Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection
Published on: September 21, 2015
Related Concept Videos
01:13Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
01:26Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
01:20Drugs for Peptic Ulcer Disease: Prostaglandin Analogs as Mucosal Protective Agents
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease
01:24Pathophysiology of Peptic Ulcer Disease: Mucosal Defense Factors
01:30Peptic Ulcer Disease I: Introduction
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...