Continuation of proton pump inhibitors from hospital to community.
OBJECTIVE
To evaluate the appropriateness of initiation of proton pump inhibitor (PPI) treatment in hospital, the quality of discharge information, and any association with continued treatment in the community.


METHODS
Survey of all inpatients newly initiated on a PPI in June-August 2003. Assessment of appropriateness of therapy and completeness of discharge information; assessment of continuation of PPI therapy in the community after 6 months.


RESULTS
Thirty-five of 58 patients (60%) were considered appropriately commenced on PPI treatment. Less than 25% of patients discharged on a PPI had discharge information recommending duration of treatment or review. In the "appropriate" group 30 patients (86%) were discharged on omeprazole, and 13/21 (62%) evaluable patients remained on this at 6 months. In the "inappropriate" group 15 (65%) were discharged on omeprazole, and 10/14 (71%) evaluable patients remained on this at 6 months. Older patients remained on omeprazole for a longer duration but appropriateness of commencement did not influence the duration of treatment. Dose titration was attempted for 10 (29%) patients including three from the "inappropriate" group.


CONCLUSIONS
Care should be taken to commence PPIs only when clinically indicated. Discharge information to GPs, especially recommendations for duration of treatment and/or dose titration, requires improvement.
Grant
Kenneth
K
Pharmacy Department, Dunedin Hospital, Dunedin, New Zealand.
Al-Adhami
Noor
N
Tordoff
June
J
Livesey
Jocelyn
J
Barbezat
Gil
G
Reith
David
D
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000494:pharmacology / Q000627:therapeutic use; D003142:Communication; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D004341:Drug Evaluation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000494:pharmacology / Q000627:therapeutic use*; D010351:Patient Discharge / Q000592:standards / Q000706:statistics & numerical data*; D054328:Proton Pump Inhibitors; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D009853:Omeprazole