To evaluate the impact of clinical pharmacist-led appropriate acid suppression therapy stewardship program in hospitalized older patients.
This prospective, nonrandomized controlled study was conducted in older patients who ordered proton pump inhibitor (PPI) at admission in an internal medicine service of tertiary training and research hospital. In the intervention group, clinical pharmacist-led services (including medication reconciliation and medication review) were conducted during hospitalization and at discharge by using the guidelines and potentially inappropriate medications (PIM) criteria \[American Geriatric Society-AGS Beers Criteria©, 2019\]. Medication Appropriateness Index (MAI), inappropriate PPI cost, and hospitalization for gastrointestinal bleeding within 1 year after discharge were calculated in both groups
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
250
Clinical pharmacist provided medication reconciliation and medication review during the hospital stay.
Marmara University
Istanbul, Turkey (Türkiye)
Appropriateness of Proton Pump Inhibitors Usage
The rate of appropriateness use of proton pump inhibitors based on the guidelines at hospital stay
Time frame: during hospital stay, an average of 14 days
Potentially Inappropriate Proton Pump Inhibitors Usage
The rate of potentially inappropriate use of proton pump inhibitors based on American Geriatric Society Beers Criteria© 2019
Time frame: at discharge, an average of 14 days after admission to hospital
Clinical outcome
The number of patients who hospitalized for bleeding within 1 year after discharge
Time frame: 1 year
Cost saving during hospital stay
Medication cost for inappropriate PPI during hospital study
Time frame: during hospital stay, an average of 14 days
Medication Appropriateness Index for Proton Pump Inhibitors at hospital stay
Medication Appropriateness Index (MAI); included 10 items. Each item was weighted from 1-3. The highest score per medication was 18. Higher scores of this index represent more inappropriateness of each medication.
Time frame: during hospital stay, an average of 14 days
Cost saving after discharge
Medication cost for potentially inappropriate PPI after discharge
Time frame: a month
Medication Appropriateness Index for Proton Pump Inhibitors at discharge
Medication Appropriateness Index (MAI); included 10 items. Each item was weighted from 1-3. The highest score per medication was 18. Higher scores of this index represent more inappropriateness of each medication.
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Time frame: at discharge, an average of 14 days after admission to hospital