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Impact of a clinical pharmacist-led stewardship program for the appropriate use of acid suppression therapy in older hospitalized patients: a non-randomized controlled study

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Abstract

Background

The potentially inappropriate use of the proton pump inhibitors is prevalent in older adults.

Aim

To evaluate the impact of a clinical pharmacist-led stewardship program for the appropriate use of acid suppression therapy in older hospitalized patients.

Method

This parallel nonrandomized controlled study was conducted at an internal medicine service of a tertiary training and research hospital between September 2019 and August 2021. Older patients (≥ 65 years old and received proton pump inhibitors within 48 h of admission) were allocated to two groups according to their number of medical file records, whether odd or even, two groups: control and clinical pharmacist-led stewardship program for the appropriate use of acid suppression therapy (including medication reconciliation and medication review) during the hospital stay. Primary outcome measures were the rate of appropriate use of proton pump inhibitors during hospitalization and potentially inappropriate proton pump inhibitor use at discharge.

Results

The rate of appropriate proton pump inhibitor use during hospitalization was significantly higher in the clinical pharmacist-led program (n = 100) than in the control group (n = 97) (46.4% vs. 79.0%; P < 0.001). The rate of potentially inappropriate proton pump inhibitor use at discharge was significantly lower (61.7% vs. 35.1%; P < 0.05) in the clinical pharmacist-led program among the older patients discharged with a proton pump inhibitor prescription.

Conclusion

A clinical pharmacist-led stewardship program for the appropriate use of acid suppression therapy improved the rate of appropriate proton pump inhibitor use and reduced the potentially inappropriate proton pump inhibitor use during the hospital stay.

Trial Registration

NCT05113667 (17 October 2021-registered retrospectively).

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Authors and Affiliations

  1. Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, Istanbul, Turkey

    Hatice Ikra Dumlu, Mesut Sancar & Betul Okuyan

  2. Department of Internal Medicine, Health Sciences University, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey

    Ali Ozdemir

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  1. Hatice Ikra Dumlu
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Correspondence to Betul Okuyan.

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Dumlu, H.I., Sancar, M., Ozdemir, A. et al. Impact of a clinical pharmacist-led stewardship program for the appropriate use of acid suppression therapy in older hospitalized patients: a non-randomized controlled study. Int J Clin Pharm 44, 914–921 (2022). https://doi.org/10.1007/s11096-022-01394-8

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