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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
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Clinical pharmacist-led services | Experimental | Clinical Pharmacist-led Appropriate Acid Suppression Therapy Stewardship Program |
|
| Control group | No Intervention | Usual care |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Clinical Pharmacist-led Appropriate Acid Suppression Therapy Stewardship Program | Other | Clinical pharmacist provided medication reconciliation and medication review during the hospital stay. |
| Measure | Description | Time Frame |
|---|---|---|
| Appropriateness of Proton Pump Inhibitors Usage | The rate of appropriateness use of proton pump inhibitors based on the guidelines at hospital stay | 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 | at discharge, an average of 14 days after admission to hospital |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical outcome | The number of patients who hospitalized for bleeding within 1 year after discharge | 1 year |
| Cost saving during hospital stay | Medication cost for inappropriate PPI during hospital study |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Betul Okuyan | Marmara University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Marmara University | Istanbul | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35449351 | Derived | Dumlu HI, Sancar M, Ozdemir A, Okuyan B. Impact of a clinical pharmacist-led stewardship program for the appropriate use of acid suppression therapy in older hospitalized patients: a non-randomized controlled study. Int J Clin Pharm. 2022 Aug;44(4):914-921. doi: 10.1007/s11096-022-01394-8. Epub 2022 Apr 21. |
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| 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. | during hospital stay, an average of 14 days |
| Cost saving after discharge | Medication cost for potentially inappropriate PPI after discharge | 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. | at discharge, an average of 14 days after admission to hospital |