Valuation of Stress Ulcer Prophylaxis Use and Associated Factors at Adult Medical Ward and Intensive Care Unit of Tikur Anbessa Specialized Hospital; A Cross-sectional Study
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Date
2021-07
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Addis Abeba University
Abstract
Stress ulcer is an inflammatory condition involving the gastric mucosa that may appear at some
point of physiological stress such as serious illness. Prophylaxis against stress ulcers using Acidsuppressive
therapy (AST), such as proton pump inhibitors (PPIs) and histamine-2 receptor
antagonists (H
2
RAs), often is used to prevent gastric complications, in patients with serious
illnesses as they have a high risk of developing gastric ulceration and bleeding. Currently there is
a growing concern about improper use of stress ulcer prophylaxis (SUP) in hospitalized patients.
Hence, this study was aimed to determine appropriateness and associated factors for the use of
SUP among patients treated at adult medical ward and intensive care unit of TASH. An
institutional based Cross-Sectional study was conducted from August 9
th
, 2019 to December 9
,
2019. Data was collected prospectively from 368 patient medical records. The data were entered
into Epi-info version 7 and then exported to and analyzed using Statistical Package for Social
Sciences, version 25. Descriptive statistics were used to summarize the data while multivariable
binary logistic regression analysis was used to determine factors associated with appropriateness
of SUP use. P-value <0.05 was considered as statistically significant. The median age of the study
participants was 32 years. Of the included study participants, 144 (39.13%) were on SUP; among
patients on SUP more than one-third of them (39.13%) received SUP without an appropriate
indicationand140 (62.50 %) patients had indications but did not receive SUP. In multivariable
logistic regression, patients who were on NG tube feeding, patients with coagulopathy and history
of UGIB, PUD and gastritis showed statically significant association with inappropriateness of
SUP use. Inappropriate SUP use was observed in significant number of study participants. Greater
proportion of this inappropriateness was attributed to the underutilization of SUP for high-risk
patients. Hence, it is necessary to implement and comply to standardized SUP guidelines for ICU
and medical ward patients in our hospital setting.
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Keywords
Tikur Anbessa Specialized Hospital, Stress Ulcer Prophylaxis, Acid Suppressive Therapy, Hospitalized Patients