Authors (including presenting author) :
Chan TC(1), Chan WK(2), Wong KW(2), Ng WC(2), Chu Lily(3), Luk KHJ(1), Chan HWF(1)
Affiliation :
(1) Department of Medicine and Geriatrics, TWGHs Fung Yiu King Hospital
(2) Nursing, CGAT, HKWC CCS
(3) Pharmacy, FYKH
Introduction :
Lansoprazole is a kind of proton pump inhibitor (PPI). It is one of the major PPI that could be dissolved in water and hence it is more suitable for patient having non oral feeding (i.e. feeding through Ryle’s tube or PEG tube). On the other hand, Lansoprazole is one of the top 5 medications with highest expenditure in FYKH. FYKH M&G launched a lansoprazole review program in April 2019.
Objectives :
To ensure effective use of resource by reviewing indication and use of lansoprazole
Methodology :
This is a joint program between Sandy Bay Hospital Drug and Therapeutic committee, FYKH pharmacy, HKWC CGAT and FYKH M&G doctors. FYKH pharmacy generate CGAT patient name list on lansoprazole. HKWC CGAT review feeding status of those patient i.e. Non oral feeding versus oral feeding. For patients on oral feeding but taking lansoprazole, printed reminders are attached to their CGAT folder to remind attending doctor to review use of lansoprazole. Attending doctor will either continue lansoprazole, change to H2 blocker, change to other equally effective PPI or sign off if clinically not indicated.
Result & Outcome :
The program was launched in April 2019. In August 2019, number of CGAT patients on lansoprazole reduced from 275 to 209 (25% reduction). Number of CGAT patients on oral feeding AND on lansoprazole reduce from 105 to 39 (63% reduction). In summary, lansoprazole prescription review program facilitates more cost effective use of lansoprazole in HKWC CGAT patients.
