Irrational use of proton pump inhibitors in general practise.
Approved indication
Food Drug Administration
Inappropriate
Proton pump inhibitors
Journal
Irish journal of medical science
ISSN: 1863-4362
Titre abrégé: Ir J Med Sci
Pays: Ireland
ID NLM: 7806864
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
28
06
2018
accepted:
17
08
2018
pubmed:
24
8
2018
medline:
22
6
2019
entrez:
24
8
2018
Statut:
ppublish
Résumé
Proton pump inhibitors (PPI) are widely used among general practitioners (GP) and hospital doctors alike as a first-line agent for the management of various approved conditions. However, PPIs do have an established side-effect profile that can be over looked when prescribing these agents outside of their Food Drug Administration (FDA) indications. The aim of this audit is to establish that PPIs are often prescribed without any clear documented indication as to why, particularly in the elderly population, despite multiple previous studies conducted which showed an over-use of these medicines. We conducted a retrospective observational study of the patients admitted to an acute hospital in Ireland in February 2018. A cohort of patient charts were pulled from medical records and reviewed. Medical notes, GP letters, discharge summaries and prescriptions were reviewed in order to establish the primary indication for PPI prescription. One hundred seventy-four (n = 174) inpatient records were randomly assessed during the audit. Of these patients, 85 of them were taking PPIs regularly. 54.7% (n = 46) were prescribed a PPI without any documented indication. 46.4% (n = 39) of these patients were > 75 years of age. 54.7% (n = 46) of patients were prescribed esomeprazole. The commonest indication for prescribing PPIs was to reduce the risk of gastric ulceration associated with NSAID use, which was 68.4% (n = 26) of those who were prescribed a PPI in accordance with guidelines. Irrational prescribing of PPIs continues both in hospital and in general practise. It is imperative that the side-effects of these medicines are weighed against the benefit and cost effectiveness, especially in the elderly population where polypharmacy remains a substantial concern.
Sections du résumé
BACKGROUND
BACKGROUND
Proton pump inhibitors (PPI) are widely used among general practitioners (GP) and hospital doctors alike as a first-line agent for the management of various approved conditions. However, PPIs do have an established side-effect profile that can be over looked when prescribing these agents outside of their Food Drug Administration (FDA) indications.
AIMS
OBJECTIVE
The aim of this audit is to establish that PPIs are often prescribed without any clear documented indication as to why, particularly in the elderly population, despite multiple previous studies conducted which showed an over-use of these medicines.
METHODS
METHODS
We conducted a retrospective observational study of the patients admitted to an acute hospital in Ireland in February 2018. A cohort of patient charts were pulled from medical records and reviewed. Medical notes, GP letters, discharge summaries and prescriptions were reviewed in order to establish the primary indication for PPI prescription.
RESULTS
RESULTS
One hundred seventy-four (n = 174) inpatient records were randomly assessed during the audit. Of these patients, 85 of them were taking PPIs regularly. 54.7% (n = 46) were prescribed a PPI without any documented indication. 46.4% (n = 39) of these patients were > 75 years of age. 54.7% (n = 46) of patients were prescribed esomeprazole. The commonest indication for prescribing PPIs was to reduce the risk of gastric ulceration associated with NSAID use, which was 68.4% (n = 26) of those who were prescribed a PPI in accordance with guidelines.
CONCLUSION
CONCLUSIONS
Irrational prescribing of PPIs continues both in hospital and in general practise. It is imperative that the side-effects of these medicines are weighed against the benefit and cost effectiveness, especially in the elderly population where polypharmacy remains a substantial concern.
Identifiants
pubmed: 30136221
doi: 10.1007/s11845-018-1891-1
pii: 10.1007/s11845-018-1891-1
doi:
Substances chimiques
Proton Pump Inhibitors
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
541-544Références
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