title: The effectiveness of prophylactic proton pump inhibitors for prevention of non-steroidal anti inflammatory drugs associated gastric and duodenal ulcers in elderly.
abstract: Aims was undertaken to ensure concomitant usage of proton pump inhibitors (PPIs) with Non-Steroidal Anti-inflammatory Drugs (NSAIDs) in Elderly, in order to avoid upper gastrointestinal (GI) symptoms and ulcers.
  
  
  METHODS
  Reviewing of 386 patients' prescription on the EMIS (Egton Medical Information Systems) Web, on April 2014. Checking who have not been prescribed PPIs with NSAIDs, offering them appointment for prescription and discussion about risks and benefits of PPIs. Re-audit of 390 patients' prescription on the EMIS Web, on July 2014. Exclusion criteria in the audit and re-audit were; NSAIDs usage for more than 3 years, contra-indications for PPIs, and patients who declined inclusion in the audit.
  
  
  RESULTS
  In the first audit cycle, a total of 386 patients' prescription reviewed, 23 (6%) patients were not prescribed PPIs with NSAIDs and were eligible for PPIs prescription. Those patients were contacted by post, an appointment arranged for them and prescribed the PPIs. 12 weeks later a re-audit was done, showed that all patients (100%) who are prescribed NSAIDs are prescribed prophylactic PPIs. None of the patients who are prescribed NSAIDs and PPIs concomitantly developed upper GI symptoms or ulcers.
  
  
  CONCLUSIONS
  The audit increased the awareness of the junior doctors of the importance of concomitant prescription of PPIs with NSAIDs, in accordance with the electronic Medical Compendium (eMC) guidelines, to prevent upper GI symptoms and ulcers. That was reflected in the re-audit having 100% of the patients prescribed NSAIDs and PPIs concomitantly.
authors.affiliation: Wrexham Maelor Hospital, UK, 87 Bron y Nant, Croesnewydd Road, Wrexham, LL13 7TZ, UK. b_o_k2002@hotmail.com.
authors.forename: Babikir
authors.initials: B
authors.lastname: Kheiri
authors.affiliation: Trauma and Orthopaedics, Maccles field DGH, UK.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mabrouk
authors.affiliation: High Street Surgery, Waters Green Medical Centre, UK.
authors.forename: Imran
authors.initials: I
authors.lastname: Ahmed
authors.affiliation: Wrexham Maelor Hospital, UK.
authors.forename: Hashim
authors.initials: H
authors.lastname: Khan
authors.affiliation: Wrexham Maelor Hospital, UK.
authors.forename: Azeem S
authors.initials: AS
authors.lastname: Sheikh