Overuse of acid suppressive therapy in hospitalised patients with pulmonary diseases

Objectives: Overuse of acid suppressive therapy (AST) has been reported in hospitalised patients, but the use in specific patient categories is unexplored. We assessed the use of and indication for AST and upper endoscopic investigations in hospitatised patients on a pulmonary ward compared with patients on other wards. Methods: 301 patients were enrolled in the study. 162 were hospitalised on a pulmonary ward with a control group consisting of 139 from both a surgical and general internal medicine ward. Adequate indications for AST were those strongly supported by medical Literature. Results: Among the 301 patients enrolled, 132 (44%) used AST. 78 (59%) had no adequate indication for AST. On the pulmonary ward 79 (49%) patients used AST, compared to only 10 (20%) on the internal medicine ward (P<0.05). On the pulmonary ward 68% of the patients had no adequate indication for AST, which was more common than inappropriate use of AST on the control wards (P<0.05). The most common inadequate indication for AST was peptic ulcer prophylaxis during corticoidsteroid therapy. Conclusion: In hospitatised patients a significant overuse of AST was observed, particularly among pulmonary patients. More adequate use of AST can contribute to substantial savings for the health-care system. (C) 2003 Elsevier Ltd. All rights reserved.