Guidelines Can Cut Nonindicated Acid-Suppressing Rx in Infants
Decrease in nonindicated prescription of PPIs/H2RAs in young infants from mean of 7.5 to zero per month
WEDNESDAY, Nov. 22, 2017 (HealthDay News) -- Implementation of a guideline can reduce nonindicated use of proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs) among newborns, according to a study published online Nov. 21 in Pediatrics.
Asimenia Angelidou, M.D., Ph.D., from Boston Children's Hospital, and colleagues developed and implemented a guideline for the use of PPIs and H2RAs in order to reduce nonindicated prescriptions among infants <1 month corrected age from a baseline of 7.5 to four per month. Interventions and plan-do-study-act cycles included guideline implementation, revision of guidelines based on staff feedback, and education of staff. Outcomes were compared over an eight-month baseline period and two post-implementation periods that spanned 19 months.
The researchers found that there was a reduction in nonindicated prescription of PPIs/H2RAs from a mean of 7.5 to zero per month. Concurrently, there was a decrease in total PPI/H2RA prescriptions from a mean of 11.5 to 2.5 per month. Over time, the rates of the balancing measure and potentially related complications remained stable.
"Implementation of an evidence-based guideline in our unit led to a significant decrease in nonindicated use of acid-suppressing medications and reduced the burden of exposure to PPIs/H2RAs. This intervention could feasibly be implemented in other similar inpatient settings," the authors write.