Improving Concordance Between Use of Proton Pump Inhibitors and Prescribing Guidelines

Abstract

Objective: To determine the effect of a request form, together with removal of proton pump inhibitors (PPIs) from ward stock, on concordance between use of PPIs and prescribing guidelines, and compare the results with a previous non‐interventional audit. Design: Drug utilisation review. Setting: 800‐bed metropolitan hospital. Participants: 101 patients with a completed PPI request form. Data were compared to a previous audit undertaken on 253 patients in 1999. Main outcome measures: Recorded upper gastrointestinal pathology; compliance with prescribing guidelines; PPI usage data. Results: The proportion of patients appropriately investigated increased from 72% (183/253) in 1999 to 92% (93/101, p = 0.004 ). Compliance with prescribing criteria increased from 23% (57/253) in 1999 to 43% (43/101, p = 0.003). PPI usage decreased by 30% compared with the corresponding quarter of 1999. Conclusions: The removal of PPIs from ward imprest along with the introduction of a PPI request form was associated with a significant improvement in compliance with prescribing guidelines, an increase in the proportion of patients appropriately investigated, and a reduction in PPI usage.