PMID- 19006542
OWN - NLM
STAT- MEDLINE
DCOM- 20110506
LR  - 20151119
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Linking)
VI  - 29
IP  - 2
DP  - 2009 Jan
TI  - The effects of guideline implementation for proton pump inhibitor prescription on 
      two pulmonary medicine wards.
PG  - 213-21
LID - 10.1111/j.1365-2036.2008.03875.x [doi]
AB  - BACKGROUND: It has been demonstrated that 40% of patients admitted to pulmonary 
      medicine wards use proton pump inhibitors (PPIs) without a registered indication. 
      AIM: To assess whether implementation of a guideline for proton pump inhibitor 
      (PPI) prescription on pulmonary medicine wards could lead to a decrease in use 
      and improved appropriateness of prescription. METHODS: This prospective study 
      comprised two periods, i.e. the situation before and after guideline 
      implementation. In each period, 300 consecutive patients were included. We 
      registered patient characteristics, medications and occurrence of upper 
      gastrointestinal-related disorders. RESULTS: After implementation, fewer patients 
      were started on PPIs [21% vs. 13%; odds ratio (OR): 0.56; 95% confidence interval 
      (CI): 0.33-0.97] and more users discontinued their use; however, the latter was 
      not significant (3% vs. 6%; OR for continuation: 0.56; 95% CI: 0.14-2.23). 
      Multivariable logistic regression analysis confirmed that PPI use during 
      hospitalization decreased after implementation (adjusted pooled OR: 0.54; 95% CI: 
      0.32-0.90). Implementation did not result in a change in reported reasons for PPI 
      prescription. There was no significant difference in the occurrence of upper 
      GI-related disorders in the first 3 months after discharge. CONCLUSIONS: 
      Guideline implementation for PPI prescription on two pulmonary medicine wards 
      resulted in a reduction in the number of patients starting PPIs during 
      hospitalization, but appropriateness of prescribing PPIs was not affected. 
      Further studies are needed to determine how appropriateness of PPI prescription 
      on pulmonary medicine wards can be further improved.
FAU - van Vliet, E P M
AU  - van Vliet EP
AD  - Department of Gastroenterology and Hepatology, Erasmus MC-University Medical 
      Center Rotterdam, Rotterdam, The Netherlands. evelynvanvliet@hotmail.com
FAU - Steyerberg, E W
AU  - Steyerberg EW
FAU - Otten, H J A M
AU  - Otten HJ
FAU - Rudolphus, A
AU  - Rudolphus A
FAU - Knoester, P D
AU  - Knoester PD
FAU - Hoogsteden, H C
AU  - Hoogsteden HC
FAU - van Gelder, T
AU  - van Gelder T
FAU - Kuijpers, P M J C
AU  - Kuijpers PM
FAU - Siersema, P D
AU  - Siersema PD
LA  - eng
PT  - Journal Article
DEP - 20081022
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
EIN - Aliment Pharmacol Ther. 2009 Feb;29(3):350. Kuipers, E J [corrected to Kuijpers, 
      P M J C]; Siersma, P D [corrected to Siersema, P D].
MH  - Adult
MH  - Aged
MH  - Drug Prescriptions/standards
MH  - Drug Utilization/statistics & numerical data
MH  - Female
MH  - Gastroesophageal Reflux/*drug therapy
MH  - Guideline Adherence/statistics & numerical data
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Compliance/statistics & numerical data
MH  - Peptic Ulcer/*drug therapy
MH  - Practice Guidelines as Topic/*standards
MH  - Practice Patterns, Physicians'/statistics & numerical data
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Pulmonary Medicine/standards
EDAT- 2008/11/14 09:00
MHDA- 2011/05/07 06:00
CRDT- 2008/11/14 09:00
PHST- 2008/11/14 09:00 [pubmed]
PHST- 2011/05/07 06:00 [medline]
PHST- 2008/11/14 09:00 [entrez]
AID - APT3875 [pii]
AID - 10.1111/j.1365-2036.2008.03875.x [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2009 Jan;29(2):213-21. doi: 
      10.1111/j.1365-2036.2008.03875.x. Epub 2008 Oct 22.