Quality of stress ulcer prophylaxis in a universitary hospital in Brazil
DOI:
https://doi.org/10.11606/issn.1679-9836.v99i2p122-127Keywords:
Disease prevention, Gastric ulcer, Gastric ulcer/prevention & control, Prescriptions, Proton pump inhibitors, Histamine H2 antagonists, Hospitalization, ProphylaxisAbstract
Aims: Though recommended for patients with high risk for upper gastrointestinal bleeding, stress ulcer prophylaxis is not always correctly prescribed in most hospitals. The objective of this study is to evaluate the adequation of stress ulcer prophylaxis in a universitary hospital. Methods: A cross-sectional analysis of the medical prescriptions of patients hospitalized in clinical, surgical and critical units of a universitary hospital was performed during 30 days. Prescriptions of patients using gastric protectors for a non-prophylactic purpose were excluded. The criteria for stress ulcer prophylaxis evaluation was based on recommendations from UpToDate® online database. Results: 358 prescriptions were analyzed, of which 17 were excluded. Of the 341 prescriptions included for stress ulcer analysis, 205 (60.1%) prescriptions were incorrect. Overprescription was the main reason of inadequacy, found in 175 cases (85.4%). The inadequacies in the prescriptions of the surgical units (80%) were higher when compared to the clinical (54.1%) and critical units (52.5%) (p < 0.001). Conclusions: important rates of incorrect stress ulcer prophylaxis prescriptions were found, mainly due to overprescription. Higher rates of inadequacies were found in surgical units. This scenario highlights the lack of scientific guidelines, efficient local protocols and professionals’ knowledge or acceptance regarding stress ulcer prophylaxis.
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