Evaluation of Omeprazole prescription for stress ulcer prophylaxis in a public trauma referral hospital: monocentric cross-sectional study
DOI:
https://doi.org/10.30968/jhphs.2025.162.1206Abstract
Objective: To evaluate the compliance to indication and prescription of Omeprazole, for stress ulcer prophylaxis in intensive care units and and hospital wards, in a public emergency and urgency hospital that is a referral in trauma, according to scientific evidence and criteria used in the present study. Method: This is a retrospective cross-sectional study. The research was carried out over a period of one day, on March 15,2023. Clinical data, previous medical history, health conditions, and eletronic prescriptions were analysed. Data were collected from all hospitalized patients aged 18 years or older. Patients without a Hospital Admission Authorization and those using omeprazole for other treatment purposes were excluded. To assess the indication for prophylaxis, the recommendations from the UpToDate database were used, on the risk factors for stress ulcers, in this database, were also listed in the guideline of the Portuguese Society of Intensive Care or in the BMJ-Best Practice, according to the practice guideline “Gastrointestinal bleeding prophylaxis for critically ill patients: a clinical practice guideline”. The data were analysed in the R software, version 4.1.1, and the results were presented in tables. Results: A total of 307 patients were screened, of whom 254 were considered eligible for evaluation of prophylaxis indication. Overall, 61.4%of patients showed adequate use. However, for 72.8% of patients prescribed omeprazole, there was no indication for its use, and among patients with an indication, prophylaxis was omitted for 17.1%. The non-critical patients’ wards had a percentage of 88.9% of patients prescribed prophylaxis, but without indication, while intensive care units had 31.4%. Conclusion: The study showed a considerable inadequacy in the use of stress ulcer prophylaxis in non-critical wards and, although smaller, a relevant inadequacy in intensive care units. Therefore, stands out the importance of establishing institutional interventions, such as a clinical protocol, to guide prescription practice.
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