title: Use of proton-pump inhibitors and their associated risks among frail elderly nursing home residents.
abstract: OBJECTIVE
  The aim of this study is to investigate the use of proton-pump inhibitors (PPI) and their associated risks among frail elderly nursing home residents.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  General practice.
  
  
  METHODS
  An assessment of residents (n = 1987, mean age 83.7 years) in all nursing homes in Helsinki was carried out in February 2003. Data included demographic characteristics, symptoms such as diarrhea, vomiting and constipation, use of various drugs, and medical diagnoses.
  
  
  RESULTS
  Coded data analysis with NCSS statistical program. Multivariate logistic regression analysis served to determine which variables were independently associated with diarrhea; variables which were statistically significant or near p < 0.05 in univariate analyses were included.
  
  
  RESULTS
  Altogether 433 residents were on PPIs. The factors associated with regular PPI use in univariate analyses included poor functional status, higher number of comorbidities, higher number of medications and lactose intolerance. The users had suffered from a prior ventricular or duodenal ulcer, cancer and coronary heart disease more often than the non-users. In accordance with our hypothesis, the users of PPIs more often had diarrhea (19.7%) than the non-users (12.9%) (p < 0.001), and they had a prior hip fracture (28.5%) more often than the non-users (19.4%) (p < 0.001). In logistic regression analysis the use of PPIs had an independent association with diarrhea (OR 1.60 (95% CI 1.20 to 2.15).
  
  
  CONCLUSIONS
  Physicians should avoid unnecessary long-term use of PPIs, particularly among frail elderly long-term care patients.
authors.affiliation: Helsinki City Health Center, Home Nursing Services, City of Helsinki, Finland.
authors.forename: Mariko
authors.initials: M
authors.lastname: Teramura-Grönblad
authors.forename: Helka
authors.initials: H
authors.lastname: Hosia-Randell
authors.forename: Seija
authors.initials: S
authors.lastname: Muurinen
authors.forename: Kaisu
authors.initials: K
authors.lastname: Pitkala
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003248:Constipation / Q000139:chemically induced; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000139:chemically induced; D005260:Female; D016330:Frail Elderly; D006620:Hip Fractures / Q000150:complications; D006801:Humans; D008297:Male; D009735:Nursing Homes; D019338:Polypharmacy; D054328:Proton Pump Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D012307:Risk Factors; D013997:Time Factors; D014839:Vomiting / Q000139:chemically induced
chemical_list: D054328:Proton Pump Inhibitors