Administration of stress ulcer prophylaxis has been recommended for specific patients in the intensive care unit setting.
However, this practice has been extrapolated to care of non-intensive care unit patients without evidence to support need or efficacy.
Dr Joel Heidelbaugh and colleagues from California examined the practice of stress ulcer prophylaxis in a non-intensive care unit of a university hospital setting.
The researchers gave specific attention to resource utilization.
The research team retrospectively reviewed the charts of adult non-intensive care unit admissions.
The patients were admitted to 1 family medicine and 5 general internal medicine teaching services over a consecutive 4-month period.
Proportion of patients prescribed stress ulcer prophylaxis was ascertained after exclusion of patients receiving treatment.
|54% were discharged unnecessarily on antisecretory therapy
|American Journal of Gastroenterology|
The team excluded patients that were admitted on antisecretory therapy, or were prescribed antisecretory therapy for non-stress ulcer prophylaxis indications.
Annual cost estimates were calculated assuming full compliance.
Of 1,769 patient admissions, 22% received stress ulcer prophylaxis and 54% of these were discharged home on antisecretory therapy.
The team found that none of these patients met evidence-based criteria for appropriate stress ulcer prophylaxis.
Inpatient stress ulcer prophylaxis cost $11,024 over the 4 months of the study, and annual cost of $44,096.
The researchers observed that outpatient costs based on discharge prescriptions were $16,924, and annual cost of $67,695.
The total cost expenditure was $27,948, and annual expense adding to $111,791.
Dr Heidelbaugh's team concludes, “Stress ulcer prophylaxis is overutilized in the non-intensive care unit setting, and patients are often discharged unnecessarily on antisecretory therapy, resulting in significant cost expenditure.”
“Interventions to ensure appropriate use of stress ulcer prophylaxis should decrease resource expenditures without detrimental impact on quality of care.”