SHM Converge Scientific Abstract ePoster Gallery-Decreasing the Misuse of Proton Pump Inhibitors for Gi Prophylaxis

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This project evaluated and reduced inappropriate proton pump inhibitor (PPI) use for gastrointestinal stress ulcer prophylaxis at Saint Francis Health System in Tulsa, Oklahoma. The goal was to create a multidisciplinary PPI Task Force to measure baseline misuse, implement interventions, and assess their impact.<br /><br />The study used a three-phase design. Phase 1 established baseline PPI use in adult patients admitted to the Yale Campus from February 2020 to January 2021. Patients were excluded if they were already taking PPIs at home, had a GI specialist order, were high-risk for stress ulcers (such as trauma, burns, mechanical ventilation, spinal cord injury, or neurologic surgery), had an active GI bleed, received the first dose in the ICU, or had a documented indication for acid suppression. Phase 2 introduced provider education on best-practice PPI use and updated 18 order sets to align with guidelines. Phase 3 reviewed adult admissions from January 2021 to 2022 to assess the effect of those changes.<br /><br />The findings showed that PPIs were often started in the hospital for inappropriate prophylaxis and continued at discharge, contributing to unnecessary cost, complications, and readmissions. After education and order set revisions, pantoprazole use decreased substantially: 60% when targeted order sets were used and 40% overall. Drug expenses fell, fewer patients were discharged on PPIs, and readmissions decreased. The study could not measure long-term benefits such as avoiding chronic adverse effects.<br /><br />Overall, the project concluded that education plus order set redesign are effective stewardship strategies for reducing unnecessary PPI prescribing. The authors recommend applying this approach to other medication stewardship opportunities, forming targeted workgroups, and updating order sets to support evidence-based practice.

Asset Subtitle

Prodromos M. Angelidis

Meta Tag

Author List Prodromos M. Angelidis

Category Innovations

Concept Proton Pump Inhibitor

Concept Gastrointestinal Ulcer Prophylaxis

Concept Inappropriate Prescribing

Concept Hospitalized Adult Patient

Concept Discharge Prescribing

Distinguished Non-Finalist

Presenter Organization Saint Francis Health System, Tulsa Oklahoma

Presenting Author Prodromos M. Angelidis

Track Quality Improvement

Keywords

proton pump inhibitor

PPI stewardship

stress ulcer prophylaxis

medication misuse

provider education

order set redesign

pantoprazole

hospital prescribing

drug cost reduction

readmission reduction

Proton Pump Inhibitor

Gastrointestinal Ulcer Prophylaxis

Inappropriate Prescribing

Hospitalized Adult Patient

Discharge Prescribing