Appropriateness of gastric antisecretory therapy in hospital practice.
BACKGROUND
Recent data indicate an exponential increase in proton pump inhibitor (PPI) prescribing, and concerns are raised regarding the appropriateness of these prescriptions and the financial implications.


OBJECTIVE
To survey the appropriateness of PPI prescription in a cohort of patients in a tertiary referral hospital.


METHODS
Prescription records of all inpatients on a randomly selected day were reviewed. The appropriateness of prescription and relevant investigations were identified by interview of patients, review of patient records and of a computerised endoscopy records system.


RESULTS
Thirty-two per cent (87 of 272) of all patients were on PPIs. A valid indication for therapy was not apparent in 63% of the patients on PPIs with the only predictive factor for inappropriate prescription being increasing age. Only 36 of the 87 patients on PPIs had undergone appropriate investigations for their gastrointestinal symptoms. Gender, age, speciality of admission or duration of hospital stay did not influence the appropriateness of prescription or performance of relevant investigations.


CONCLUSIONS
There appears to be a widespread and inappropriate use of PPIs in hospital practice.
Sebastian
S S
SS
Department of Gastroenterology, Adelaide Hospital, Tallaght, Dublin, Ireland.
Kernan
N
N
Qasim
A
A
O'Morain
C A
CA
Buckley
M
M
D000368:Aged; D011307:Drug Prescriptions / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D017723:Drug Utilization Review; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data; D004791:Enzyme Inhibitors; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007494:Ireland; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D054328:Proton Pump Inhibitors; D012189:Retrospective Studies
D004791:Enzyme Inhibitors; D054328:Proton Pump Inhibitors