title: Prescribing patterns of proton pump inhibitors in older hospitalized patients in a Scottish health board.
abstract: OBJECTIVE
  Proton-pump inhibitors (PPI) are extensively prescribed worldwide. However, little information is available on PPI prescribing patterns, associated clinical and demographic factors, and potential drug-drug interactions in frail older patients.
  
  
  METHODS
  Data on clinical and demographic characteristics, and full medication exposure were collected in a consecutive series of 361 older patients (age 84 ± 7 years) admitted to two acute geriatric admission units (Aberdeen, National Health Service Grampian) between 1 February 2010 and 30 June 2010. A set of predetermined criteria was used to assess appropriateness of PPI prescribing.
  
  
  RESULTS
  PPI were prescribed in 148 patients (41.0%). Inappropriate overprescribing was observed in 127 patients (35.2% of the study population, 85.8% of patients prescribed PPI). PPI were inappropriately not prescribed in 20 patients (48.8% of patients with an indication for PPI treatment). Regression analysis showed that the total number of non-PPI prescribed drugs (OR 1.08; 95%CI 1.01-1.15) and a higher Charlson Comorbidity Index (OR 1.08; 95%CI 1.001-1.16) were independently associated with inappropriate PPI overprescribing. Potential drug-drug interactions were found in 75 patients (22.8% of the study population), mainly in patients with PPI overprescribing.
  
  
  CONCLUSIONS
  Inappropriate PPI prescribing is common in frail older hospitalized patients, and might increase the risk of drug-drug interactions. Polypharmacy and comorbidity were independently associated with inappropriate PPI prescribing in this group.
authors.affiliation: Division of Applied Medicine, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.
authors.forename: Anna Amrit
authors.initials: AA
authors.lastname: Jarchow-Macdonald
authors.forename: Arduino A
authors.initials: AA
authors.lastname: Mangoni
mesh_terms: D000369:Aged, 80 and over; D004347:Drug Interactions; D005260:Female; D016330:Frail Elderly; D006760:Hospitalization; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008297:Male; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012606:Scotland
chemical_list: D054328:Proton Pump Inhibitors
keywords: drug-drug interactions; older patients; prescribing; proton-pump inhibitors