■过量使用酸抑制剂是人类和小动物患者的普遍现象,导致潜在的有害胃肠道(GI)和非GI后果。共识声明对临床实践中兽医处方习惯的影响尚未得到充分评估。这项研究旨在比较质子泵抑制剂(PPI)的处方习惯,奥美拉唑,在美国兽医内科学院(ACVIM)发表关于合理使用胃肠保护剂的共识声明之前和之后,在一家学术兽医教学医院的狗中。
■回顾性比较了2017年和2021年奥美拉唑在狗中的处方习惯评估。选择这些年份是为了反映共识声明发表之前和之后的12个月。每年随机选择一百只狗。剂量,给药频率,治疗持续时间,分析了一种以上胃保护剂的并行处方和奥美拉唑处方的适应症.
■在发表2018年ACVIM共识声明后,发现接受奥美拉唑q12h(p<0.0001)或在≥4周治疗后逐渐减少剂量(p>0.0001)的病例显着增加。考虑到这些迹象,与第一阶段相比,第二阶段奥美拉唑的适当处方也有显著增加(p<0.0001).参与奥美拉唑处方的16名临床医生中有15名(94%)表示,他们阅读共识声明改变了他们在狗中使用PPI的临床实践。
■这些结果支持ACVIM共识声明对学术兽医医院中奥美拉唑明智处方的有益影响。这些结果不应推断为第一意见兽医实践,应进一步努力确保PPI的处方谨慎,明确适应症,并定期审查继续给药的适当性,以最大程度地减少可能的风险和不良药物相互作用。
UNASSIGNED: Overprescribing of
acid suppressants is a common phenomenon in human and small animal patients, leading to potential deleterious gastrointestinal (GI) and non-GI consequences. The impact of
consensus statements on veterinary prescribing habits in clinical practice have not been fully evaluated. This study aimed to compare the prescribing habits of the proton pump inhibitor (PPI), omeprazole, in dogs in an academic veterinary teaching hospital before and after the publication of the American College of Veterinary Internal Medicine (ACVIM) consensus statement on rational use of gastrointestinal protectants.
UNASSIGNED: Evaluation of the prescribing habits of omeprazole in dogs during the years 2017 and 2021 was retrospectively compared. These years were selected to reflect a 12-month period prior to and following the publication of the
consensus statement. One hundred dogs from each year were randomly selected. Dose, frequency of administration, duration of treatment, concurrent prescription of more than one gastroprotectant and indications for prescribing omeprazole were analyzed.
UNASSIGNED: A significant increase in the cases that received omeprazole q12h (p < 0.0001) or that underwent a tapering dose after ≥4 week-therapy (p > 0.0001) was detected after the publication of the 2018 ACVIM consensus statement. Considering the indications, there was also a significant increase in the appropriate prescription of omeprazole in the second compared to the first period of study (p < 0.0001). Fifteen of 16 clinicians (94%) involved in the prescription of omeprazole indicated that their reading of the
consensus statement had changed their clinical practice regarding PPI administration in dogs.
UNASSIGNED: These results support the beneficial impact of the ACVIM
consensus statement on the judicious prescribing of omeprazole in an academic veterinary hospital. These results should not be extrapolated to first-opinion veterinary practices, and further efforts should be made to ensure that PPIs are prescribed prudently with a clear indication and regular review of the appropriateness of continued administration to minimize possible risks and adverse drug interactions.