To evaluate the effectiveness of the plan-do-check-act (PDCA) cycle combined with a drug use pathway in managing the rational use of proton pump inhibitors (PPIs) hospital-wide.

Based on evidence-based medicine, PPI treatment and prophylactic medication pathways were established and implemented through the PDCA cycle. The changes in PPI usage rationality, quarterly average sales amount and its proportion of total drug consumption, medication frequency (DDDs), usage intensity (AUD), medication structure and intravenous usage rate in hospitalized patients were compared before implementation (fourth quarter of 2023) and after implementation (first to third quarters of 2024).

After the implementation of medication pathways, the rationality of PPI use across the hospital significantly improved. The prescription compliance rate increased from 95.17% (571 prescription/600 prescription) to 98.50% (589 prescription /600 prescription), and the order compliance rate rose from 93.33% (140 prescription /150 prescription) to 97.33% (149 prescription /150 prescription). Costs also decreased, with quarterly consumption dropping from 37.82 to 25.98 million yuan, with a reduction of 31.31%, and the cost proportion declining from 0.97% to 0.80%, with a decrease of 17.53%. The reduction in usage intensity was greater than the total volume, with AUD decreasing from 208.48 to 126.28 (with a 39.43% reduction) and DDDs dropping from 153 071.29 to 103 490.17 (with a 32.39% reduction). The medication structure continued to optimize, with the proportion of high-cost PPIs decreasing from 52.35% to 38.28% (with a 26.88% reduction), while the proportion of centralized procurement/essential drugs increased from 40.99% to 42.42% (with a 3.45% rise). The intravenous usage rate declined from 15.51% to 14.67% (with a 5.41% reduction). The intervention effectively achieved the goals of cost control, quality improvement, and compliance.

The PDCA cycle can effectively promote the implementation of drug use pathways and enhance the level of rational drug use.