Impact of clinical pharmacists on adherence to stress ulcer prophylaxis protocol in critically ill Egyptian patients: a comparative study
Authors: Bazan, N.S., Farid, S.F. and Baines, D.L.
Journal: Drugs and Therapy Perspectives
Volume: 37
Issue: 1
Pages: 35-43
eISSN: 1179-1977
ISSN: 1172-0360
DOI: 10.1007/s40267-020-00786-y
Abstract:Background: Standardized protocols can aid in appropriate prescribing of stress ulcer prophylaxis (SUP) in the intensive care unit (ICU). The study aimed to evaluate the impact of providing a physician’s education (PhyEd) versus a PhyEd + Clinical Pharmacist (PhyEd + CPh) approach on adherence to a SUP protocol and possible cost saving in the ICU. Methods: This was a quasi-experimental study. An evidence-based SUP protocol was developed by a clinical pharmacy team at an Egyptian ICU. Physicians were provided with educational sessions, information regarding the protocol, and latest SUP guidelines over a 1-month period. All adult patients admitted to one of the two ICU floors during the 6-month study period were eligible for inclusion. Patients admitted with an indication for acid suppressive therapy and those who stayed in the ICU for < 48 h were excluded. Patients were divided into two groups based on their ICU floor: PhyEd (1st floor) and PhyEd + CPh (2nd floor). Clinical pharmacists provided interventions regarding protocol adherence only for patients on the 2nd floor. Results: A total of 177 patients were included. SUP protocol non-adherence, calculated as the percentage of inappropriate (i.e., did not meet all the criteria in the protocol) patient-days, was significantly lower in the PhyEd + CPh group than in the PhyEd group (64.7% vs 90.9%; p < 0.0001). Bleeding events were comparable in both groups. The total actual cost saved due to protocol adherence was $US149.44 ($US118.95 in the PhyEd + CPh group + $US30.49 in the PhyEd group). The estimated total cost saved due to protocol adherence was $US948.56. Conclusion: Clinical pharmacists’ daily interventions decreased non-adherence to the SUP protocol, and provided a significant decrease in hospital expenditures with no influence on adverse effects.
Source: Scopus