Changes in intravenous pantoprazole utilization following two sequential interventions in a tertiary referral...

Intravenous (IV) pantoprazole is an effective proton pump inhibitor (PPI) with certain evidence-based indications for acid-related disorders. However, many studies demonstrated the considerable inappropriate administration of IV pantoprazole, resulting in adverse drug reactions and a financial burden. Irrational pantoprazole use necessitates educational and regulatory interventions. This study aimed to assess the effects of a hospital-wide program to optimize pantoprazole use in a tertiary‑care, referral, university-affiliated hospital.

This study was conducted in three 45-day evaluation phases, before and after two sequential interventions, including the implementation of institutional guidelines with educational sessions and an order entry form (OEF). The use and appropriateness of IV pantoprazole were evaluated in each evaluation phase, and the hospital consumption (DDD/100 Bed-Days) of IV pantoprazole was estimated from 2014 to 2021.

The appropriate use of stress ulcer prophylaxis (SUP) in the first-day evaluation of the third phase increased significantly by 7% compared to the first and second evaluation phases (p = 0.03), while other indications remained unchanged. The total number of vials per patient over the 5 days decreased significantly during the three evaluation phases of the study (Coefficient = -0.05, SE = 0.02, p = 0.003).

Sequential interventions in our study reduced IV pantoprazole consumption. However, we did not observe a significant improvement in appropriate IV pantoprazole use except for SUP in one of the assessments. Although the reasons behind this should be studied, more comprehensive, continuous, and effective interventions should have been considered to achieve acceptable change.