The Impact of Pharmacist Interventions on the Inappropriate Use of Acid-Suppression Therapy

OBJECTIVE We assessed the impact of acid suppression therapy (i.e., ranitidine or proton pump inhibitors) on iron supplementation and its ability to maintain or alter laboratory values that are commonly associated with anemia. METHODS This was a prospective, observational trial. The primary outcome was changes in serum iron levels from baseline. Secondary outcomes were changes in hemoglobin (Hgb) and hematocrit (Hct), transfusions, and maintenance of an alkalotic gastric pH. RESULTS Thirty-four patients (mean 24 ± 43 months) met inclusion criteria. The serum iron levels increased to 50.9 ± 24.6 mcg/dL by day 3. The mean difference from baseline was 1.5 mcg/dL (95% CI, 1.14–1.98, p = 0.0056). Gastric pH increased to 4.68 ± 1.49 on day 5. The mean Hgb and Hct increased on day 5 to 10 ± 1.06 g/dL and 29.6% ± 3.27%, respectively. The mean difference of Hgb was 1.15 g/dL (95% CI, 0.51–1.78, p = 0.0009). The mean difference of Hct was 3.04% (95% CI, 1.11–4.97, p = 0.0032). CONCLUSIONS The use of antacids along with oral ferrous sulfate supplementation did not affect the absorption of iron. Serum iron, Hgb, and Hct all showed statistically significant increases despite combined antacid and iron therapy. Thus, despite use of antacids, combination use showed increases in iron absorption.

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703 - Decrease in the Inappropriate Use of Acid Suppression Therapy in the Geriatric Age Group by Educational Intervention

Gastroenterology ◽

10.1016/s0016-5085(18)30899-0 ◽

2018 ◽

Vol 154 (6) ◽

pp. S-144

Author(s):

Sankalp Dwivedi ◽

Jaya Edukulla ◽

Sindhu Rajendra ◽

Sandesh Murali ◽

Serge A. Sorser ◽

...

Keyword(s):

Educational Intervention ◽

Acid Suppression ◽

Age Group ◽

Inappropriate Use ◽

Acid Suppression Therapy

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Inappropriate Use of Gastric Acid Suppression Therapy in Hospitalized Patients with Clostridium difficile—Associated Diarrhea: A Ten-Year Retrospective Analysis

ISRN Gastroenterology ◽

10.5402/2012/902320 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Sadat Rashid ◽

Dhyan Rajan ◽

Javed Iqbal ◽

Seth Lipka ◽

Robin Jacob ◽

...

Keyword(s):

Clostridium Difficile ◽

Gastric Acid ◽

Retrospective Analysis ◽

Practice Guidelines ◽

Hospitalized Patients ◽

Acid Suppression ◽

Inappropriate Use ◽

Acid Suppression Therapy ◽

Additional Approach ◽

Gastric Acid Suppression

Purpose. The incidence of Clostridium difficile-associated diarrhea (CDAD) has steadily increased over the past decade. A multitude of factors for this rise in incidence of CDAD have been postulated, including the increased use of gastric acid suppression therapy (GAST). Despite the presence of practice guidelines for use of GAST, studies have demonstrated widespread inappropriate use of GAST in hospitalized patients. We performed a retrospective analysis of inpatients with CDAD, with special emphasis placed on determining the appropriateness of GAST. Methods. A retrospective analysis was conducted at a multidisciplinary teaching hospital on inpatients with CDAD over a 10-year period. We assessed the use of GAST in the cases of CDAD. Data collection focused on the appropriate administration of GAST as defined by standard practice guidelines. Results. An inappropriate indication for GAST was not apparent in a majority (69.4%) of patients with CDAD. The inappropriate use of GAST was more prevalent in medical (86.1%) than on surgical services (13.9%) (P<0.001). There were more cases (67.6%) of inappropriate use of GAST in noncritical care than in critical care areas (37.4%) (P<0.001). Conclusion. Our study found that an inappropriate use of inpatient GAST in patients with CDAD was nearly 70 percent. Reduction of inappropriate use of GAST may be an additional approach to reduce the risk of CDAD and significantly decrease patient morbidity and healthcare costs.

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