The Effect of Implementing Guidelines on Proton-Pump Inhibitor Use

Proton-pump inhibitors (PPIs) are often prescribed to prevent nosocomial upper gastrointestinal bleeding (UGIB). However, multiple studies have shown that these agents are overused for this indication. Would implementing guidelines on PPI use for inpatients influence prescribing practices?

To find out, investigators at Massachusetts General Hospital compared the use of PPIs in patients admitted 1 month before and 1 month after implementation of standardized guidelines regarding PPI use for prophylaxis of nosocomial UGIB. Patients with UGIB and those treated in intensive care units were excluded.

Thirty-six percent of patients were taking PPIs at admission, 49% were prescribed PPIs during hospitalization, and 41% were prescribed PPIs at discha…