Evaluation of the Role of Clinical Pharmacist in Optimizing Stress-Related Mucosal Disease Prophylaxis in Patients Admitted to Nephrology Ward: A Prospective Quasi-Experimental Study

Prescription of acid supressive therapy (AST) for prophylaxis of stress-related mucosal disease (SRMD) in hospitalized patients is inappropriate in many cases. Therefore, this study was designed to determine the role of clinical pharmacist in optimizing prescription of these therapies.

This prospective interventional quasi-experimental study was conducted on 101 patients admitted to the Nephrology Ward in Shafa Hospital affiliated to Kerman University of Medical Sciences. All patients with a length of hospital stay of more than 24 hours were included. In the pre-intervention phase, each patient was evaluated regarding the risk of SRMD and receiving or not receiving SRMD prophylaxis. In the second phase, the clinical pharmacist actively intervened for discontinuation of AST in patients at low risk of SRMD and initiation of AST in patients who were at high risk of SRMD but did not receive any medication. Finally, in each phase of the study, the number of patients who appropriately or inappropriately received prophylactic drug was reported. Chi square test was used to analyze data.

Fifty-seven and 44 patients were evaluated in the pre-intervention and intervention phases, respectively. The number of patients who inappropriately received prophylactic drugs significantly decreased from 37 patients (77%) in the pre-intervention phase to 6 patients (31.6%) in the intervention phase (p<0.001).

Considering the effective role of the clinical pharmacist in this study, consultation with a clinical pharmacist for optimizing rational prescription of drugs for prophylaxis of SRMD in hospitalized patients is recommended.