Efficacy of education with American Society of Health system Pharmacists guidelines on the prevention of stress ulcer

Stress Ulcer Prophylaxis (SUP) is important in patients in Intensive Care
Units (ICU). In this study, we evaluated the efficacy of the American Society of Health
System Pharmacists (ASHP) guidelines, for stress ulcer prophylaxis.
Methods: In this Quasi experimental study, data of patients that admitted to the ICU of
Imam Khomeini Hospital of Urmia was recorded for three months. Then our guideline
that was selected on the basis of ASHP guidelines were presented to physicians for one
month and then patients’ data were collected again. The patients that hospitalized due to
acute gastrointestinal bleeding and died in the early hours of admission were excluded.
The data were analyzed.
Results: This study involved 234 patients, of them 112 patients (91.1%) in the pre- intervention
period and 99 patients (89.2%) in the post-intervention period had received
acid-suppressive therapy (AST) (P=0.632). Of 77 patients (62.8%) in the pre- intervention
period and 88 (79.3%) in the post-intervention period had an indication for SUP
according to our ASHP-based guideline (P=0.005). Of the patients without an indication
for SUP, 39 of 123 (31.7%) received AST in the pre-intervention period versus 18
of 111 (16.2%) in the post-intervention period (P=0.006). of 112 (91.1%) cases in the
pre-intervention period compared with 93 (83.8%) cases of the prescription drug order
was incorrect (P=0.092). Gastrointestinal bleeding were in five patients (4.1%) found
during the pre-intervention period and 8 (7.2%) cases in the post-intervention period
(P=0.295).
Conclusion: In this study the majority of cases not been in accordance with the ASHPbased
guideline and our education did not affect the quality of stress ulcer prophylaxis.
It seems that more attention to the training of physician in the prophylaxis of stress ulcer
can be effective in improving the health status of patients and additional costs may
be reduced.