The impact of pharmacist intervention on the intravenous-to-oral switch therapy of proton pump inhibitors in cardiovascular surgery

ABSTRACT

Background

The prescriptions of proton pump inhibitors (PPIs) have been widely concerned due to both huge increase in medical costs and possible long-term adverse events (AEs) caused by the improper route of drug administration. The aim of this study was to assess the effectiveness of pharmacist interventions on the clinical outcome and safety of switching from intravenous (IV) to oral PPIs therapy.

Patients and methods

A retrospective, single-center, pre- intervention (early -stage)- and intervention (later -stage) study was performed in a Chinese hospital.

Results

A total of 1736 patients were included in the study. After 12 months of interventions, significant improvements in the number of rational IV to oral switch in patients with oral switch indications were found. The median duration of oral therapy was increased, while the duration of PPIs therapy was decreased. Pharmacist interventions led to significant reductions in mean PPI costs, mean total drug costs, mean hospitalization costs, and the risk for long-term adverse events.

Conclusion

This study provides important evidence on the beneficial effect of pharmacist interventions on promoting an optimal IV to oral switch of PPIs and substantial cost saving by shortening the duration of IV PPIs therapy and reducing the risk for long-term AEs.

KEYWORDS:

• Proton pump inhibitors
• intravenous-to-oral switch therapy
• pharmacist intervention
• PPI therapy duration
• cost saving

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers in this manuscript have no relevant financial or other relationships to disclose.

Author contribution statement

JA Bao, L Zhou, MY Xu, and JJ Ma participated in the design of the trial and study methodology. L Zhou followed up with patients and collected data. JJ Ma, JA Bao, and MY Xu performed data analysis. JA Bao and MY Xu wrote the first draft of the manuscript and JJ Ma made critical revisions. All authors reviewed the manuscript and approved the final version of the manuscript.

Additional information

Funding

This paper was funded by the Suzhou Science and Technology Development Project [SYSD2019178].