EVALUATION OF CURRENT PRACTICE OF STRESS ULCER PROPHYLAXIS IN PATIENTS ADMITTED TO INTENSIVE CARE UNITS IN THE GAZA STRIP- PALESTINE

Abstract

This study aimed at assessing the degree of adherence of Stress ulcer prophylaxis (SUP) practice to the American Society of Health-System Pharmacists (ASHP) guidelines in intensive care units (ICUs) at three hospitals in the Gaza Strip, Palestine. This was a prospective study that utilized chart review methodology for data collection. Four aspects of SUP practice were assessed: indication, dose, route of administration and duration. The study enrolled 442 ICU patients with a median (Interquartile range, IQR) age of 49.0 (36.6) years. More than half the patients (55.7%) were males. Coagulopathy was the most common major risk factor for stress ulcer, presented in 73 (16.5%) patients, while the use of corticosteroid therapy was the most common minor risk factor presented in 93 (21%) patients. SUP was administered to 426 (96.4%) patients, of which 86.9% received ranitidine and 13.1% received PPIs. Overall adherence and indication adherence rates to guidelines were 16.7% and 36.4%, respectively. Appropriate dose, route and duration of SUP were found in 63.6%, 68.2%, and 88.1% of the evaluated doses, respectively. Of the 426 patients prescribed SUP, 48 (11.3%) developed adverse effects. This study revealed suboptimal SUP practice in the investigated hospitals and the need to apply strategies to improve SUP use patterns.