Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 7, 2050312119827409
eCollection

Assessment of Pharmacologic Prophylaxis Use Against Stress Ulcer in the Medical Wards of University of Gondar Hospital

Affiliations

Assessment of Pharmacologic Prophylaxis Use Against Stress Ulcer in the Medical Wards of University of Gondar Hospital

Boressa Adugna Horsa et al. SAGE Open Med.

Abstract

Background: Critically ill patients with moderate-to-severe physiologically stressful event are at high risk of developing stress ulcers. The use of pharmacological prophylaxis significantly reduces the incidence of stress ulcer in high-risk patients.

Objective: The aim of this study was to assess the use of pharmacological prophylaxis for stress ulcer in the medical wards of University of Gondar Hospital.

Methods: A cross-sectional study design was used. In total, 234 patients were selected through simple random sampling technique. The risk of stress ulcer development was assessed using Evidence-Based Medicine Guideline for stress ulcer prepared by Orlando Regional Medical Center. SPSS version 21 was used for data analysis.

Result: The most common acute risk factor to stress ulcer was coagulopathy (18.4%), followed by hypoperfusion (9.8%). The concomitant non-steroidal anti-inflammatory drug use (16.7%), mild-to-moderate brain or spinal cord injury (11.1%), and concomitant or recent corticosteroid use (9.4%) were frequently seen risk factors that necessitate administration of a prophylaxis. In total, 82 (35%) study participants were given stress ulcer prophylaxis, among which 52 (63.4%) were given without indication. The most commonly used drug class in the prevention of stress ulcer was proton pump inhibitors (76/82, 92.7%). In total, 43 (18.4%) study subjects were not given stress ulcer prophylaxis while there was clear indication. Patients with a long hospital stay and a diagnosis of central nervous system disorders had significant risk for inappropriate stress ulcer prophylaxis use.

Conclusion: In this study, inappropriate use of prophylaxis for stress ulcer was common. The higher proportion of inappropriateness was due to the use of stress ulcer prophylaxis while there was no enough indication. We recommend future researchers to assess the cost and impact of inappropriate stress ulcer prophylaxis use, and the physicians should be adherent to the standard guidelines.

Keywords: Inappropriate; proton pump inhibitors; stress ulcer prophylaxis.

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Similar articles

See all similar articles

References

    1. Heidelbaugh JJ, Inadomi JM. Magnitude and economic impact of inappropriate use of stress ulcer prophylaxis in non-ICU hospitalized patients. Am J Gastroenterol 2006; 101(10): 2200–2205. - PubMed
    1. Rumbaugh K, Cole K, May A. VUMC multidisciplinary surgical critical care service: gastrointestinal stress ulcer prophylaxis guidelines. 2013, https://www.vumc.org/trauma-and-scc/files/trauma-and-scc/public_files/Manual/Gastrointestinal%20Stress%20Ulcer%20Prophylaxis%20Guidelines.pdf
    1. Cook DJ, Fuller HD, Guyatt GH, et al. Risk factors for gastrointestinal bleeding in critically ill patients. New Engl J Med 1994; 330(6): 377–381. - PubMed
    1. Dellinger RP, Levy MM, Rhodes A, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med 2013; 41(2): 580–637. - PubMed
    1. Eisa N, Bazerbachi F, Alraiyes AH, et al. Q: do all hospitalized patients need stress ulcer prophylaxis? Cleve Clin J Med 2014; 81(1): 23–25. - PubMed

LinkOut - more resources

Feedback