Reasons for initiation of proton pump inhibitor therapy for hospitalised patients and its impact on outpatient prescription in primary care

Villamañán, Elena; Ruano, Margarita; Lara, Catalina; Suárez-de-Parga, José Manuel; Armada, Eduardo; Álvarez-Sala, R.; Pérez, E Rodríguez; Herrero, Alicia

doi:10.17235/reed.2015.3882/2015

Cited by 14 publications

(14 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The prevalence of PPI prescription in our hospital is high with more than half the patients on PPI treatment. This is in line with other studies, conducted in the US and in Europe, where the prescription rate can reach up to 80% [7,35]. A study conducted in a Qatari hospital highlighted that the prescription of acid suppressive therapy concerned 53% of patients and the proportion of PPI and histamine 2 antagonists was 89% and 11% respectively [36].…”

Section: Discussionsupporting

confidence: 88%

See 1 more Smart Citation

Snapshot of proton pump inhibitors prescriptions in a tertiary care hospital in Switzerland: less is more?

et al. 2019

View full text Add to dashboard Cite

Background Proton pump inhibitors are among the most widely prescribed drugs in the world, but more than half of the indications for prescription are unjustified. The misuse of this therapeutic class has heavy consequences such as additional health costs, adverse drug reactions following long-term use and gastric acid rebound when the proton pump inhibitor is discontinued. Objective The overprescription of proton pump inhibitors is therefore becoming a public health problem, which led us to evaluate their use within the Geneva University Hospitals. Setting Patients hospitalized in two divisions of the department of internal medicine of the Geneva University Hospitals on a single day. Methods This is a register-based cross-sectional study and it collected data about the prescription pattern of proton pump inhibitors by consulting the electronic records of patients included. Main outcome measure To determine if the proton pump inhibitors prescription is made according to the market authorization and the available guidelines. Results Hundred-eighty patients were included. 54% of patients were on proton pump inhibitors, 29% of whom had their treatment initiated at hospital. Of the indications for treatment, 72% were not justified and 63% of the justified indications did not have an adequate dosage. Therefore, in all patients with a proton pump inhibitor at hospital, only 11% had a justified indication with an adequate dose. Finally, 87% of known home prescriptions were renewed on admission and among them, 71% did not have a justified or possibly justified indication according to the guidelines. Conclusion Indication for treatment inside the hospital was not justified in 72% of patients and only 11% had a justified indication with an adequate dosage. Precise guidelines with evidence-based indications and adequate daily doses would help to correctly prescribe proton pump inhibitors. Moreover, patients should benefit from a thorough evaluation of their treatment. Impact of findings on practice statements• Around 70% of the renewed prescriptions for proton pump inhibitors on admission did not have a justified indication. • As many as 72% of the hospitalised patients had an unjustified indication for a proton pump inhibitor.

show abstract

Section: Discussionsupporting

confidence: 88%

“…Moreover, 29% of the prescriptions in our study were new prescriptions initiated on admission to the hospital. This is slightly lower than percentage reported in Villamanan et al study, where 49% of patients had a treatment initiated on admission [35].…”

Section: Discussioncontrasting

confidence: 63%

Snapshot of proton pump inhibitors prescriptions in a tertiary care hospital in Switzerland: less is more?

et al. 2019

View full text Add to dashboard Cite

show abstract

“…First, it confirms a high level of unwarranted PPI use in patients admitted to hospital. A number of studies in different countries, including Spain, show similar PPI overuse rates in the inpatient setting (58% and 74%, respectively) (10,(13)(14)(15)(16)(17). Findings are also consistent with those of other reported studies (7,(18)(19)(20) as regards the primary causes of inappropriate PPI prescription -stress ulcer prophylaxis in patients with a low risk for GI bleeding, and "gastroprotection" in polymedicated individuals off drugs with gastroerosive potential.…”

supporting

confidence: 79%

PPIs: Between overuse and underprescription when really necessary

C¹,

Aguilera²,

Santiago³

2015

Rev Esp Enferm Dig

View full text Add to dashboard Cite

Hydrochloric acid gastric secretion plays, among its primary physiological foundations, a role as protective barrier against infection with external agents from the diet and also contributes to the digestion of ingested food. However, this secretion is a critical factor shared by a number of highly prevalent diseases involving the upper gastrointestinal tract. Paradigms of such conditions include gastroduodenal peptic ulcer and gastroesophageal reflux disease.

show abstract

“…However, prescriptions for PPIs in elderly patients are often long term (>8 weeks), 46 47 and PPIs that are newly started during hospitalisation are often continued after discharge. 48 Finally, our assessment did not include potential prescription omissions 7 or other clinically important outcomes, such as mortality and adverse drug events.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of potentially inappropriate medications at admission and discharge among hospitalised elderly patients with acute medical illness at a single centre in Japan: a retrospective cross-sectional study

Komagamine

2018

BMJ Open

View full text Add to dashboard Cite

ObjectiveTo determine the prevalence of potentially inappropriate medications (PIMs) at admission and discharge among hospitalised elderly patients with acute medical illness in Japan.DesignA retrospective single-centre cross-sectional study.ParticipantsHospitalised patients aged 65 years or older admitted for pneumonia, heart failure, ischaemic stroke, acute coronary syndrome, chronic obstructive pulmonary disease or asthma, gastrointestinal bleeding, urinary tract infection or epilepsy from September 2014 to June 2016 who were still alive at discharge.Main outcome measuresThe primary outcome was the proportion of patients taking at least one PIM at admission and discharge. PIMs were defined based on the 2015 American Geriatric Society Beers Criteria. Temporal changes in the proportion of patients taking at least one PIM from admission to discharge were also evaluated.ResultsDuring the study period, 689 eligible patients were identified. The median patient age was 82.0 years (IQR 76.0–88.0), 348 (50.5%) were men and the median number of medications at admission was 5.0 (IQR 3.0–8.0). The proportions of patients taking any PIMs at admission and discharge were 47.9% (95% CI 44.2% to 51.6%) and 25.1% (95% CI 21.9% to 28.4%), respectively. The proportion of patients taking any PIMs was significantly lower at discharge than at admission (reduction rate 0.48, 95%, CI 0.41 to 0.53).ConclusionsA substantial proportion of hospitalised elderly patients with acute medical illness took PIMs at admission and discharge. These findings should be confirmed at other hospitals in Japan.

show abstract

Reasons for initiation of proton pump inhibitor therapy for hospitalised patients and its impact on outpatient prescription in primary care

Cited by 14 publications

References 37 publications

Snapshot of proton pump inhibitors prescriptions in a tertiary care hospital in Switzerland: less is more?

Snapshot of proton pump inhibitors prescriptions in a tertiary care hospital in Switzerland: less is more?

PPIs: Between overuse and underprescription when really necessary

Prevalence of potentially inappropriate medications at admission and discharge among hospitalised elderly patients with acute medical illness at a single centre in Japan: a retrospective cross-sectional study

Contact Info

Product

Resources

About