Investigating the role of pharmacist in rationalizing the administration of injectable proton pump inhibitor drugs in an educational hospital

Introduction: Intravenous Pantoprazole is one of most commonly used drugs in inpatient setting of hospitals. Inappropriate use of this drug imposes a high cost on the patient and health system as well as complications such as clostridium difficile, pneumonia, osteoporosis and hypomagnesemia. Pharmacovigilance and rationalizing drug use have been defined as the main tasks of clinical pharmacist. Imam Hussein pharmacovigilance department has decided to intervene in the process of drug utilization through the stress ulcer prophylaxis (SUP) guideline to modify the pattern of PPI use. Methods: This cross sectional study has been done between January to July 2017 in a teaching hospital affiliated to Shahid Beheshti Medical University, Tehran, Iran. In this study using international protocols, guideline for IV pantoprazole was developed and approved by gastroenterology and clinical pharmacy specialists. Prospective audit and feedback for patients receiving IV pantoprazole based on pre-designed SUP guideline done by a trained pharmacy student. SPSS ver. 20 was used for statistical analysis. Results & Discussion: In total 446 patients received IV pantoprazole during study period 78.25% of prescription was out of guideline. The physician in charge accepted feedbacks in 63.89% of patients which led to 8.3% vials decrease in consumption of IV pantoprazole compared to same period of time. The highest percentage of reduction in IV Pantoprazole prescription was observed in the surgery ward (37.39%; p=0.01), while this reduction was not statistically significant in other investigated wards (p> 0.05). In addition, the highest percentage of acceptance of pharmacist s recommendation was related to the neurosurgery ward (90%). The percentage of recommendation acceptance in other wards was related to the internal ward (72.9%), surgery ward (66.03%) and neurology ward (52.9%), respectively. Conclusion: Although, the implementation of the guideline lead to overall reduction in the administration of IV pantoprazole, however by passing the time of implementing the guideline, a decline in its effectiveness was observed. This conclusion emphasizes the importance of continuous monitoring of the IV pantoprazole prescriptions.

کلیدواژه ها:

IV Pantoprazole ، Pneumonia ، Hypomagnesemia ، Clinical pharmacist