Category: Federal Forum Posters
Purpose: The purpose of this quality improvement project is to implement a PPI de-escalation protocol and educate providers on how to minimize PPI overuse in home based primary care (HBPC) and long-term care (LTC) patients. Research has shown PPI overuse can put patients at risk for developing enteric infections, bone fractures and nutritional deficiencies. The intent is to inform HBPC and LTC providers of the risks associated with PPI overuse and the benefits of implementing the PPI de-escalation protocol. The data collected will assess the effectiveness of utilization of the protocol along with provide education on reducing PPI prescribing.
Methods: The patients will be identified using the hospital's electronic medical record (EMR) system. The review will take place between October 1, 2018 to April 1, 2019. The patients will include HBPC and LTC patients aged 65 years or older, who have been receiving PPI therapy for more than 6 months and have not had a gastroenterology (GI) clinic follow-up. A list of eligible patients will be given to the providers. The providers will be presented with an in-service on adverse effects associated with PPI overuse, as well as they will be educated on appropriate ways to de-escalate patients on PPIs and the advantages of the de-escalation protocol. The protocol was previously approved by gastroenterology service and the P&T committee and was effective in discontinuing PPIs in 16% of HBPC patients last year. The protocol will assist providers in reducing PPI use among their patients. The EMR will be reviewed monthly to see how many patients were effectively de-escalated off PPIs. The primary endpoint of this initiative will be to assess the number of HBPC and LTC patients effectively tapered off PPIs within the 6-month time frame.
Results: not applicable
Conclusion: not applicable
Merlyn Chazhikat– PGY1 Pharmacy Resident, Northport Veterans Affairs Medical Center, Houston, TX