Retrospective Review and Analysis of Stress Ulcer Prophylaxis at Methodist Hospital of Indiana 2014

Retrospective Review and Analysis of Stress Ulcer Prophylaxis at Methodist Hospital of Indiana 2014. Brian Bates, PharmD Candidate. Dan Kendzierski, PharmD Candidate. Preceptor: Kevin Tuohy, PharmD. Background: Acid suppressing medications are used to reduce acid production in the stomach by binding to H+/K+ - ATPase (proton pump inhibitors) or histamine (H2) receptor (H2 antagonists). Patients who benefit from these medications are those with conditions secondary to increased gastric acidity including: gastric hypersecretion, GERD, duodenal ulcer disease. Patients experiencing a high amount of stress due to other physical conditions (i.e. patients within the ICU), short term NSAID therapy, or corticosteroid therapy can also benefit from acid suppressing medications. Due to the trend of overprescribing acid suppressing agents, it is important to evaluate the need of these medications based on individual patient factors as evidenced in the 1998 ASHP stress ulcer prophylaxis guidelines. The guidelines state that acid suppressing therapy is indicated in patients one of the following: coagulopathy (platelet count \u3c50,000 per m3, INR \u3e1.5, or PTT \u3e2x baseline), mechanical ventilation for \u3e48 hours, history of GI ulceration/bleeding within the past year, traumatic brain injury, traumatic spinal cord injury, burn injury, or two or more of the following (sepsis, ICU stay \u3e1week, occult GI bleeding of at least 6 days, or glucocorticoid therapy (more than 250 mg hydrocortisone or equivalent.) Study Objective: To examine and evaluate the use of acid suppressing agents at Methodist Hospital of Indiana. Methods: The study objective will be met using a retrospective chart review at Methodist Hospital of Indianapolis. The patient population consists of patients admitted to the neuropsychiatry/neurosurgery unit between June 1, 2014 and June 30, 2014. Inclusion criteria for the study are patients aged 18 to 89. The exclusion criteria includes pregnant patients and those not in the specific age range. The sample size for the study is up to 150 patients. The above mentioned indications for therapy will be used to identify appropriate acid suppressive therapy. Significance: The ultimate goal of this study is to increase awareness of the stress ulcer prophylaxis guidelines and the overprescribing of acid suppressive agents. This study will serve as a tool for prescribers and act as a major factor in determining appropriate therapy for patients