Literature DB >> 23065088

Physicians' opinions of stress ulcer prophylaxis: survey results from a large urban medical center.

Charles P Koczka1, Laura B Geraldino-Pardilla, Adam J Goodman.   

Abstract

BACKGROUND: Stress ulcer prophylaxis (SUP) has been increasingly prescribed for patients admitted to medical wards. The knowledge, attitudes, and practices of those in the healthcare profession regarding use of SUP in medical wards are understudied.
METHODS: A survey consisting of closed-ended questions and multiple-choice queries was handed out during grand rounds.
RESULTS: One hundred people (39 attending physicians, 61 residents) completed the survey. More attending physicians (41 vs. 30 %) believed SUP was indicated for patients treated in a non-intensive-care medical ward (P = 0.2357). All residents preferred a proton-pump inhibitor (PPI) for SUP compared with 85 % of attending physicians (P < 0.05). Despite equal agreement that PPIs were not harmless, more attending physicians than residents agreed that using PPIs increased the risk of community-acquired pneumonia (P < 0.05). More residents than attending physicians agreed on the use of SUP for patients suffering from major burns and for those with liver failure. In situations of respiratory distress not requiring intubation and in cases of steroid treatment for a chronic obstructive pulmonary disease flare, more attending physicians than residents felt SUP was required. Approaching a statistically significant difference, more attending physicians than residents felt that being too busy to question SUP indication and the perception of PPIs as harmless affected decision making.
CONCLUSION: Despite the publication of guidelines, misuse of gastric acid suppressants continues to occur, even by attending physicians. More complete understanding of the need and occasion for SUP use should result in more cautious use.

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Year:  2012        PMID: 23065088     DOI: 10.1007/s10620-012-2423-x

Source DB:  PubMed          Journal:  Dig Dis Sci        ISSN: 0163-2116            Impact factor:   3.199


  31 in total

1.  Concordance between use of proton pump inhibitors and prescribing guidelines.

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2.  Continuation of proton pump inhibitors from hospital to community.

Authors:  Kenneth Grant; Noor Al-Adhami; June Tordoff; Jocelyn Livesey; Gil Barbezat; David Reith
Journal:  Pharm World Sci       Date:  2006-10-26

3.  Preventive measures for stress ulcers in burn patients.

Authors:  T Rath; L R Walzer; G Meissl
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4.  Brief report: Reducing inappropriate usage of stress ulcer prophylaxis among internal medicine residents. A practice-based educational intervention.

Authors:  Joshua D Liberman; Chad T Whelan
Journal:  J Gen Intern Med       Date:  2006-05       Impact factor: 5.128

Review 5.  Stress-induced ulcer bleeding in critically ill patients.

Authors:  Tauseef Ali; Richard F Harty
Journal:  Gastroenterol Clin North Am       Date:  2009-06       Impact factor: 3.806

6.  Mechanisms underlying the gastroprotective action of glucocorticoids released in response to ulcerogenic stress factors.

Authors:  L P Filaretova; T T Podvigina; T R Bagaeva; A Tanaka; K Takeuchi
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Review 7.  Stress ulcer prophylaxis in hospitalized patients not in intensive care units.

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9.  [Deficiency of glucocorticoid production delays the healing of acute gastric mucosal erosion and chronic ulcers in rats].

Authors:  L P Filaretova; T R Bagaeva; T T Podvigina; O Iu Morozova
Journal:  Ross Fiziol Zh Im I M Sechenova       Date:  2003-09

10.  An intervention on discharge polypharmacy.

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4.  Assessment of pharmacologic prophylaxis use against stress ulcer in the medical wards of University of Gondar Hospital.

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5.  Critical Care Pharmacists and Medication Management in an ICU Recovery Center.

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Review 6.  Use of proton pump inhibitors for the provision of stress ulcer prophylaxis: clinical and economic consequences.

Authors:  Jeffrey F Barletta; David A Sclar
Journal:  Pharmacoeconomics       Date:  2014-01       Impact factor: 4.981

7.  Changes in proton pump inhibitor prescribing trend over the past decade and pharmacists' effect on prescribing practice at a tertiary hospital.

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8.  Continuous improvement on the rationality of prophylactic injectable PPIs usage by a clinical pharmacist-led guidance team at a Chinese tertiary teaching hospital.

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  8 in total

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