Differences in utilisation of gastroprotective drugs between 2001 and 2005 in Australia and Nova Scotia, Canada

Tett, S. E.; Sketris, Ingrid; Cooke, Charmaine; Zanten, Sander Veldhuyzen van; Barozzi, Nadia

doi:10.1002/pds.3442

Cited by 15 publications

(14 citation statements)

References 47 publications

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“…In sensitivity analyses, data were pooled using random-effects models. In additional sensitivity analyses, data from Nova Scotia were excluded as the Nova Scotia Seniors’ Pharmacare program required specific criteria to be followed prior to PPI reimbursement until 11 January 2008 18. All meta-analyses were conducted using Stata V.11.2 (StataCorp LP, College Station, Texas, USA).…”

Section: Methodsmentioning

confidence: 99%

Proton pump inhibitors and the risk of hospitalisation for community-acquired pneumonia: replicated cohort studies with meta-analysis

Filion

Château

Targownik

et al. 2013

Gut

161

117

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ObjectivePrevious observational studies suggest that the use of proton pump inhibitors (PPIs) may increase the risk of hospitalisation for community-acquired pneumonia (HCAP). However, the potential presence of confounding and protopathic biases limits the conclusions that can be drawn from these studies. Our objective was, therefore, to examine the risk of HCAP with PPIs prescribed prophylactically in new users of non-steroidal anti-inflammatory drugs (NSAIDs).DesignWe formed eight restricted cohorts of new users of NSAIDs, aged ≥40 years, using a common protocol in eight databases (Alberta, Saskatchewan, Manitoba, Ontario, Quebec, Nova Scotia, US MarketScan and the UK's General Practice Research Database (GPRD)). This specific patient population was studied to minimise bias due to unmeasured confounders. High-dimensional propensity scores were used to estimate site-specific adjusted ORs (aORs) for HCAP at 6 months in PPI patients compared with unexposed patients. Fixed-effects meta-analytic models were used to estimate overall effects across databases.ResultsOf the 4 238 504 new users of NSAIDs, 2.3% also started a PPI. The cumulative 6-month incidence of HCAP was 0.17% among patients prescribed PPIs and 0.12% in unexposed patients. After adjustment, PPIs were not associated with an increased risk of HCAP (aOR=1.05; 95% CI 0.89 to 1.25). Histamine-2 receptor antagonists yielded similar results (aOR=0.95, 95% CI 0.75 to 1.21).ConclusionsOur study does not support the proposition of a pharmacological effect of gastric acid suppressors on the risk of HCAP.

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Section: Methodsmentioning

confidence: 99%

Proton pump inhibitors and the risk of hospitalisation for community-acquired pneumonia: replicated cohort studies with meta-analysis

Filion

Château

Targownik

et al. 2013

Gut

161

117

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“…Different PPI products have an equivalent mechanism of action and a similar clinical efficacy (Strand et al, 2017). Due to their excellent efficacy, tolerability and positive adverse event profile, PPI utilization has significantly increased all over the world (Hollingworth et al, 2010;Tett et al, 2013;Lanas, 2016;Ying et al, 2019). Besides official, evidence-based use of PPIs, less understandable and justifiable prescriptions have also occurred (Savarino et al, 2017;Savarino et al, 2018a).…”

Section: Introductionmentioning

confidence: 99%

Use of Proton Pump Inhibitors in Hungary: Mixed-Method Study to Reveal Scale and Characteristics

et al. 2020

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Background: Due to their efficacy and tolerability, utilization of proton pump inhibitors (PPI) has significantly increased worldwide. Parallel to the clinical benefits, potential longterm side effects have been observed, which, along with increasing medical expenses and potential drug interactions, justifies the analysis of the trends of utilization. Objective: The aim of the present study was to show the level, pattern, and characteristics of PPI use. Methods: We assessed the nationwide use of proton pump inhibitors in ambulatory care based on aggregated utilization data from the National Health Insurance database. The annual PPI utilization was expressed as the number of packages and as number of DDDs per 1,000 inhabitants and per year. For 2018, we estimated PPI exposure as the number of packages and as the number of DDDs per user per year. The annual reimbursement costs of proton pump inhibitors were also calculated. Moreover, three patient-level surveys were carried out in non-gastroenterological inpatient hospital departments to reveal characteristics of proton pump inhibitor use, namely dose, duration, and indication. Results: The PPI utilisation increased from 5867.8 thousand to 7124.9 thousand packages and from 41.9 to 50.4 DDD per 1,000 inhabitants and per day between 2014 and 2018. Nationwide data showed that 14% of the adult population was exposed to proton pump inhibitors in 2018, while among hospitalized patients, the prevalence of proton pump inhibitor use was between 44.5% and 54.1%. Pantoprazole was the most frequently used active ingredient, both in the nationwide data and in the patient-level surveys. In the patient-level survey in majority of patients (71.5%-80.0%) proton pump inhibitors were prescribed for prophylaxis. Many inpatients (29.4%-36.9%) used 80 mg pantoprazole per day. The average number of PPI packages per user was 6.5 in 2018 in the nationwide data. The duration of PPI therapy was typically between 1 and 5 years in the patient-level surveys and nearly 20% of the inpatients had been taking proton pump inhibitors for more than 5 years.

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“…Due to their effectiveness and perceived short-and long-term safety, PPIs account for 95% of acid suppressing medication prescriptions [1]. In Australia, PPI prescribing tripled from 45 in 2001 to 130 defined daily dose (DDD)/1000 concession beneficiaries/day in 2005 [4]. With 6.9 million prescriptions in 2014, PPIs are the third most prescribed drug group by volume and the fourth highest cost prescribed drug group in Australia [5].…”

Section: Introductionmentioning

confidence: 99%

The effect of dose and type of proton pump inhibitor use on risk of fractures and osteoporosis treatment in older Australian women: A prospective cohort study

Hoorn

Tett

Vries

et al. 2015

Bone

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Please cite this article as: van der Hoorn Mariëlle M.C., Tett Susan E., de Vries Oscar J., Dobson Annette J., Peeters G.M.E.E. (Geeske), The effect of dose and type of proton pump inhibitor use on risk of fractures and osteoporosis treatment in older Australian women: a prospective cohort study, Bone (2015Bone ( ), doi: 10.1016Bone ( /j.bone.2015 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT 2 ABSTRACT Objectives:Proton pump inhibitors (PPIs) are among the most prescribed medications worldwide, however, there is growing concern regarding potential negative effects on bone health. The aim was to examine the effect of dose and type of PPI use on subsequent use of osteoporosis medication and fractures in older Australian women. Methods:Data were included from 4432 participants (born 1921-26) Conclusion:An appropriate benefit/risk assessment should be made when prescribing PPIs, especially for esomeprazole and rabeprazole, as osteoporosis and fracture risks were increased in this cohort of elderly females subsequent to PPI prescription. Highlights Proton pump inhibitor (PPI) use in elderly (>77 years) women was associated with increased risk of decreased bone health. Increased risk of subsequent osteoporosis medication was associated with the most commonly prescribed PPI, esomeprazole, and with rabeprazole and use of multiple different PPIs.

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Differences in utilisation of gastroprotective drugs between 2001 and 2005 in Australia and Nova Scotia, Canada

Cited by 15 publications

References 47 publications

Proton pump inhibitors and the risk of hospitalisation for community-acquired pneumonia: replicated cohort studies with meta-analysis

Proton pump inhibitors and the risk of hospitalisation for community-acquired pneumonia: replicated cohort studies with meta-analysis

Use of Proton Pump Inhibitors in Hungary: Mixed-Method Study to Reveal Scale and Characteristics

The effect of dose and type of proton pump inhibitor use on risk of fractures and osteoporosis treatment in older Australian women: A prospective cohort study

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