Name: Evaluation of inappropriate stress ulcer prophylaxis continuation after discharge from the intensive care unit
Start: 2025-04-25T08:30:00-0400
End: 2025-04-25T08:45:00-0400

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Friday April 25, 2025 8:30am - 8:45am EDT

Athena I

Title: Evaluation of inappropriate stress ulcer prophylaxis continuation after discharge from the intensive care unit
Authors: Abigail McBrayer, Jamarius Carvin, Elaina Etter, Rachele Hollis
Background/Purpose: Critically ill patients that require admission to the intensive care unit (ICU) are at an increased risk of gastrointestinal (GI) stress ulcers. Stress ulcer prophylaxis (SUP) is achieved through proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs) administration. While the optimal duration of SUP therapy is unclear, current literature recommends discontinuing SUP upon resolution of risk factors, most commonly at the time of discharge from the ICU. Inappropriate SUP continuation can negatively affect both the patient and the hospital system. This study evaluates the rate of inappropriate continuation of PPIs or H2RAs for SUP after ICU discharge. 
Methods: This study was a single-center, retrospective chart review from May 1, 2023, to October 31, 2023.  Patients qualified for inclusion if they were greater than 18 years of age, received SUP during their ICU stay, were discharged from the ICU to an intermediate care unit or acute care floor, and had an active SUP order upon transfer to the non-ICU area. Patients were excluded if they had pre-existing conditions requiring acid suppressive therapy (AST) including gastroesophageal reflux disease, peptic ulcer disease, Barrett’s esophagus, and dyspepsia, were discharged directly from ICU to another healthcare facility, or were on appropriately continued AST. The primary outcome was the percentage of patients inappropriately continued PPIs or H2RAs at discharge from the ICU. Inappropriate continuation was defined as patients being continued on SUP after discharge from the ICU, when there are little to no risk factors to warrant the use of SUP. Secondary outcomes included healthcare costs, length of time on inappropriate AST, and the number of patients discharged home with a PPI or H2RA.  
Results: Throughout the study period, 406 patients were assessed for inclusion, with 180 meeting inclusion criteria. The leading reason for exclusion was patient death before ICU discharge, accounting for 55 patients (24%)

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2025 Southeastern Residency Conference

Charleen Melton, PharmD, BCCCP

Abigail McBrayer

Brittny Medenwald

Attendees (21)

2025 Southeastern Residency Conference

Charleen Melton, PharmD, BCCCP

Abigail McBrayer

Brittny Medenwald

Attendees (21)

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