Hospital use of acid-suppressive medications and its fall-out on prescribing in general practice: a 1-month survey.
BACKGROUND
Acid-suppressive medications are commonly used in hospitalized patients, but, to date, little is known about the overall use of these drugs in the hospital setting.


OBJECTIVE
To evaluate the appropriateness of acid-suppressive therapy in a large teaching hospital in northern Italy, and the fall-out of hospital prescription in general practice.


METHODS
The use of antisecretory agents was monitored for 1 month in adult patients consecutively admitted to L. Sacco University Hospital by reviewing their clinical charts. The appropriateness of each prescription was reviewed jointly by two consultant gastroenterologists.


RESULTS
A total of 46.8% of 799 hospitalized patients received acid-suppressive therapy. Ranitidine was the most frequently used drug (44.4%), followed by pantoprazole (31.8%) and omeprazole (23.0%). Stress ulcer prophylaxis and the prevention of non-steroidal anti-inflammatory drug-induced ulcer accounted for 60.4% of the indications for use. Overall, 68% of prescriptions were not appropriate as determined by consensus review; 56.4% of patients receiving unnecessary prophylactic treatment whilst in hospital were discharged on therapy, and 46% were still receiving the treatment 3 months later.


CONCLUSIONS
Acid-suppressive agents are over-used in hospitalized patients. Most of the inappropriate hospital prescriptions are for ulcer prophylaxis in low-risk patients. This unnecessary use may also induce inappropriate drug consumption in general practice.
Parente
F
F
Department of Gastroenterology, L. Sacco University Hospital, Milan, Italy. fabrizio.parente@tiscalinet.it
Cucino
C
C
Gallus
S
S
Bargiggia
S
S
Greco
S
S
Pastore
L
L
Bianchi Porro
G
G
D000863:Antacids / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004415:Dyspepsia / Q000188:drug therapy; D005194:Family Practice; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy; D006300:Health Services Misuse; D017442:Histamine Agonists / Q000627:therapeutic use; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D010437:Peptic Ulcer / Q000188:drug therapy; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data; D054328:Proton Pump Inhibitors
D000863:Antacids; D017442:Histamine Agonists; D054328:Proton Pump Inhibitors