Category: Federal Forum Posters
Purpose: Approximately 25 to 75 percent of patients on proton pump inhibitor (PPI) therapy are being treated unnecessarily and often for a prolonged duration. Long-term effects of PPI usage include an increased risk of adverse events such as fractures, pneumonia, Clostridium difficile, hypomagnesemia, vitamin B12 deficiency, kidney impairment, and dementia. This epidemic is putting many patients at a preventable risk and significantly increasing medical cost. The purpose of this quality improvement project is to decrease the number of patients that are inappropriately on proton pump inhibitors in the primary care and inpatient setting.
Methods: An algorithm will be developed to determine the appropriateness of PPI therapy and whether it can be safely discontinued or dose-reduced. The algorithm will be implemented into a new PPI deprescribing Computerized Patient Record System (CPRS) template, which will be utilized by pharmacists and providers to screen patients for appropriateness of PPI therapy.
This quality improvement project will take place for four months in the primary care clinic and upon discharge from a hospital admission. Primary care clinic providers and pharmacists will be able to evaluate their patients during their scheduled appointments. Discharging pharmacists will chart review prior to discharge counseling and complete the PPI deprescribing CPRS template to alert the provider of their recommendation.
A brief chart review will be done for each recommendation to obtain patient characteristics such as related diagnosis, age, sex, and estimated length of therapy. Multiple data systems will be utilized to obtain the discontinuation rate over the specified time-period. The outcomes will be the number of recommendations, interventions, and the discontinuation rate of PPIs over a four-month period compared to four months prior to the project start date in the primary care and discharge population.
Results: not applicable
Conclusion: not applicable
Christopher Nakagawa– Pharm.D. Candidate, The Daniel K. Inouye College of Pharmacy, University of Hawai'i at Hilo, Waialua, HI