Patients with inflammatory arthritis are more prone to have CKD. This could have serious implications, as the majority of rheumatology patients use non-steroidal anti-inflammatory drugs and different immunosuppressives, such as methotrexate. No association of kidney dysfunction was noted with inflammatory disease-specific characteristics; rather it appears to have a positive independent association with cardiovascular diseases.

Mobile phone usage is very common among the medical personnel, and this is regarded as a more efficient means of communication for mobile staff than the hospital paging system.

ObjectivesTo evaluate the appropriateness of proton pump inhibitor (PPI) prescribing by conducting an audit of medical inpatients against recommended guidelines.DesignQuestionnaire-based study. All medical wards were audited and different information was documented by patients' medical records review (both hospital visit notes and general practitioner's letters) and short interview, where we asked them to name the clinical reason for using PPI.SettingThis study was carried out in the setting of a regional hospital (537-bed, secondary care referral centre) in Ireland.ParticipantsThe study participants were all consecutive medical patients admitted to the medical wards at Waterford Regional Hospital, Waterford.Main outcome measuresThe appropriateness of PPI usage in our regional hospital by assessing the level of its prescribing against published guidelines (NICE, 2000).ResultsDuring the audit period, 205 consecutive medical inpatients were assessed. Seventy-nine percent (162 out of 205) of the studied patients were found to be using PPI. For 45% (n = 73) of patients, there was no documentation of valid indication for being on PPI. Overall, 64% of patients were prescribed PPI by hospital doctors, either during their current or previous admissions. We noted that 31% (n = 51) of patients were taking PPI for ≥2 years and another 25% of patients were using PPI for about one year. Only 12% (n = 20) of patients had undergone endoscopy procedures.ConclusionInappropriate use of PPI remains common in hospital practice. The risks of using long-term PPI must be weighed against the benefits.

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