• E Dupuis, S Pomiès, S Segui, and J-M Sénard.
• Service orthopédie, pôle anesthésie-réanimation, faculté de médecine, CHU Purpan, université Toulouse-III, place Dr.-Baylac, TSA40031, 31059 Toulouse cedex 9, France. fuzier.r@gmail.com
• Ann Fr Anesth Reanim. 2011 Nov 1;30(11):814-8.

ObjectiveTo improve the quality of proton pump inhibitors (PPI) prescription in an orthopaedic department.Study DesignProspective professional practice evaluation study.Patients And MethodsA specific protocol concerning the best practice for using PPI in the perioperative period was established by anaesthesiologists and validated by all prescribers, according to recent recommendations published by French Afssaps. PPI prescription pertinence, mainly using the oral route, was based upon the presence of clearly identified risk factors. PPI mensual consumption and severe gastric complications were analyzed and compared with those obtained from the previous year. Ten months after the beginning of the protocol, the pertinence of PPI prescription was analyzed in 20 randomly selected medical records. Data are expressed in defined daily dose (DDD).ResultsAfter one year, a 35.5% decrease in oral PPI consumption was noted (901 ± 211 before vs 581 ± 235 DDD, after, P<0.05). A similar trend to a decrease in intravenous PPI consumption was observed (40 ± 23 vs 22 ± 26, P=0.06). During the same period, the overall incidence of severe gastric complication remained stable. The PPI prescription was pertinent in 85% of selected medical records.ConclusionThis study confirmed the interest of professional practice evaluation protocols to improve PPI prescription. A strong implication of all medical staff members is mandatory to maintain such benefits over time.Copyright © 2011 Elsevier Masson SAS. All rights reserved.

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