Proton Pump Inhibitors: Their Misuse, Overuse, And Abuse

Atkins, Ashton M.

doi:10.9790/3013-32202529

Cited by 9 publications

(11 citation statements)

References 9 publications

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“…Grube et al concluded from their 2007 review that as many as 71% of general patients are given acid‐suppressive therapy without an appropriate indication. Atkins et al identified in their 2013 review that the appropriateness of hospital‐prescribed PPIs may be as low as 19%. Several studies, which examined the overuse of PPIs, emphasize the need for the development of procedures, such as frequent reviews, due to the potential risk–benefit ratio of these medicines …”

Section: Resultsmentioning

confidence: 99%

We have had a gutful: The need for deprescribing proton pump inhibitors

et al. 2017

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SummaryWhat is known and objective: Proton pump inhibitor (PPI) prescribing may often be inappropriate and expose patients to a risk of adverse effects, while incurring unnecessary healthcare expenditure. Our objective was to determine PPI usage in Australia since 2002 and review international studies investigating inappropriate PPI prescribing, including those that discussed interventions to address this issue. Methods: Australian Pharmaceutical Benefits Scheme (PBS) and RepatriationPharmaceutical Benefits Scheme (RPBS) data were analysed. A narrative literature review relevant to the objective was conducted. Time series analysis was also used to examine the trend of reported PPI appropriate use across the international studies included in this review. Results and discussion K E Y W O R D Sdeprescribing, gastro-oesophageal reflux, PPI, prescribing patterns, proton pump inhibitor

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Section: Resultsmentioning

confidence: 99%

We have had a gutful: The need for deprescribing proton pump inhibitors

et al. 2017

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“…Proton pump inhibitors (PPIs) are among the most widely used drug classes in the United States [ 1 ]. However, with their increasing use, there are come concerns about misuse and overuse [ 2 ]. Physicians often prescribe PPIs without a clear indication, at higher doses, and for a longer duration than necessary [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Internists’ Perceptions of Proton Pump Inhibitor Adverse Effects and Impact on Prescribing Practices: Results of a Nationwide Survey

et al. 2018

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BackgroundObservational studies have linked proton pump inhibitors (PPIs) with serious adverse effects. The study aimed to evaluate internists’ perceptions of PPI harms and effects on prescribing.MethodsThis was an online survey of a representative sample of the American College of Physicians in 2013. We queried familiarity with and concern about PPI adverse effects (1 - 7 Likert-type scales, anchored by “not at all” and “extremely”). We also asked how frequently (often, sometimes, rarely, or never) participants used any of three “de-escalation” strategies to stop or reduce PPIs because of concern about adverse effects: reducing patients’ PPI dose, switching to H2 blocker, or discontinuing PPI. We used multivariable logistic regression to evaluate associations between sometimes/often using any PPI de-escalation strategy and gender, time in practice, familiarity, and concern.ResultsThe response rate was 53% (487/914). Seventy percent were male, median time in practice was 11 - 15 years, and most practiced general medicine (58%). Ninety-nine percent reported at least some familiarity with reported adverse effects (mean 4.9, standard deviation (SD) 1.0), and 98% reported at least some concern (mean 4.6, SD 1.3). Sixty-three percent reported sometimes/often reducing the PPI dose, 52% switching to H2 blocker, and 44% discontinuing PPI. In multivariable analysis, familiarity with adverse effects (OR 1.66 (1.31 - 2.10) for 1-point increase, P < 0.001) and concern (OR 2.14 (1.76 - 2.61) for 1-point increase, P < 0.001) were independently associated with de-escalation. Gender and time in practice had no effects.ConclusionAlmost all internists report awareness and concern about PPI adverse effects, and most are de-escalating PPIs as a result. Research on which approach is most effective for which patients is critically important.

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“…Patients who take PPI also have a risk of gastroenteritis caused by pathogenic microorganisms. 4 The higher dose of PPI can be prescribed for the following indications: maintenance dose for severe GERD; chronic cough related to GERD; empirical diagnosis and treatment for laryngopharyngeal reflux; PPI diagnostic test for uncomplicated GERD and non-cardiac chest pain; and the prevention of peptic ulcer rebleeding. 24 In 34 cases, PPI was prescribed in an inappropriate dose related to unsuitable indications.…”

Section: S11mentioning

confidence: 99%

“…3 Certain clinical studies stated that PPIs are safe and well tolerated if taken correctly. 4 Recent studies showed some concerns about long-term PPI consumption, including PPI-clopidogrel drug interaction; the possibility of PPIs reducing calcium absorption and vitamin B12, magnesium, and iron levels; long-term acid suppression leading to the development of atropic,gastritis which could be a cancer precursor; PPI being associated with infection risks (pneumonia, Clostridium difficile); and PPIs increasing the risk of bone fractures. 2 Because of the negative effect of incorrect usage and overdose of PPIs, it is very important for physicians to only prescribe these drugs when needed.…”

Section: Introductionmentioning

confidence: 99%

“…2 Because of the negative effect of incorrect usage and overdose of PPIs, it is very important for physicians to only prescribe these drugs when needed. 4 One study in Indonesia showed that there were 55.33% correct diagnoses and treatment effectiveness was 92.38%. 5 According to Cipolle, Strand, and Morley (1998), the pharmacist has a responsibility in achieving effective treatment.…”

Section: Introductionmentioning

confidence: 99%

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Appropriate Use of Proton Pump Inhibitor in Inpatients of Central Army Gatot Soebroto Hospital

Anindita¹,

Syafhan²,

Hersunaryati³

et al. 2017

JYP

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Background: Evaluation of the use of Proton Pump Inhibitors (PPIs) perceiving the high use of PPIs and likely impacts from inappropriate use of PPPs. The aim of this study was to evaluate the use of PPI on in-patients at Gatot Soebroto Army Center Hospital. Material and Methods: the study design was observational analytic descriptive with prospective data collection method base on prescription and medical record. The sample was data of entire adult in-patients with Indonesian National Health Insurance who used PPI at Internal Diseases Department. PPI use was evaluated based on rationality and therapy effectiveness. Results: Analysis carried out on 153 PPIs therapy of 91 in-patients. The percentages of PPIs therapies with appropriate indication was 77.78%, appropriate drug selection was 77.78%, appropriate patient condition was 98.69%, appropriate dose was 4.58%, appropriate therapy duration was 66.01% and therapy effectiveness was 86.27%. Only 3.92% PPIs therapies were rational regarding all the appropriate criteria fulfillness. Conclusion: Monitoring and

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Proton Pump Inhibitors: Their Misuse, Overuse, And Abuse

Cited by 9 publications

References 9 publications

We have had a gutful: The need for deprescribing proton pump inhibitors

We have had a gutful: The need for deprescribing proton pump inhibitors

Internists’ Perceptions of Proton Pump Inhibitor Adverse Effects and Impact on Prescribing Practices: Results of a Nationwide Survey

Appropriate Use of Proton Pump Inhibitor in Inpatients of Central Army Gatot Soebroto Hospital

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