Cost estimation and adherence of medical prescriptions to guidelines of stress ulcer prophylaxis in a university hospital of Northeastern Brazil: a retrospective observational study

Abstract

Objective: Evaluate the adherence of prescriptions to the main prophylaxis guidelines for stress ulcers and estimate the expenditures incurred by inappropriate prescriptions in a university hospital in the Northeast Region of Brazil. Methods: The study was observational, cross-sectional retrospective with a qualitative approach. Medical records and prescriptions of all patients hospitalized for more tan 24 hours in non-intensive care units during a month period were analyzed. Patients under 18 years of age, those previously using acid suppressants for treatment purposes, and patients with incomplete medical records were excluded from the study. Data were collected using an instrument formulated from the main guidelines for stress ulcer prophylaxis. They were subjected to descriptive analysis, Kruskal-Wallis test with Dunn’s post-hoc, Pearson’s correlation, and logistic regression. The Odds ratio and confidence interval (95% CI) were considered to report the results of the regression model. Values of p≤0.05 were considered significant for the other tests. Results: A total of 421 users were eligible to participate in the study, most of them male and between the ages of 30 and 59. For 212 (50.3%) patients, prophylaxis for stress ulcers was prescribed, and in 210 (99%) of these there was no indication in the guidelines. The average cost per patient with improperly prescribed prophylaxis was U$8.6 (SD10.8). In the analysis, using the multiple logistic regression model,