Patients, Prescribers, and Institutional Factors Associated with Inappropriate Use of Acid Suppressive Therapy in Medical Wards: An Experience of a Single-Center in Saudi Arabia

PURPOSE: To identify factors associated with inappropriate acid-suppressive therapy (AST) use in hospitalized medical ward patients. PATIENTS AND METHODS: This was a combined retrospective cohort study reviewing the electronic medical records of medical ward in a secondary university hospital between January 2018 and July 2019, in addition to prescriber surveys about AST knowledge. We included adult patients (≥18 years old) admitted to the medical ward who received at least one dose of AST during their hospitalization. Statistical analyses included descriptive statistics and logistic regression. RESULTS: A total of 335 patients were included. Most of the patients were female (66.6%), with a mean age of 42.37 ± 17.72 years; 76% (n=256) of the study subjects were prescribed AST for an inappropriate indication. Patients who were not receiving any home medications associated with high bleeding risk had higher odds of being prescribed AST inappropriately (OR, 4.06; 95% CI, 1.09–13.8). A total of 27 physicians completed the prescriber survey, and the average prescriber’s knowledge score was 46.8 ± 15.6%. This score did not differ by the prescriber’s position. CONCLUSION: This study demonstrated the overuse of AST in the medical ward. Therefore, improving providers’ awareness about AST and implementing an AST stewardship program in institutions is necessary to limit this long-lasting issue.