title: [Survey of the prescriptions of proton pump inhibitors in patients admitted in an internal medicine ward: how is the compliance to the French guidelines?].
abstract: OBJECTIVE
  In June 2009, the national French authority for Health reported many off-label uses of proton pump inhibitors (PPI). Our objective was to analyse the justification and modalities of PPI prescriptions in patients before their admission in a department of internal medicine.
  
  
  METHODS
  Data were prospectively collected during 5months. At admission, all prescriptions of PPI by general practitioners (GP) were recorded. The accordance of the prescriptions with the marketing authorization indications and the French guidelines in terms of duration of treatment or dosage was analyzed. These informations were obtained from computerized medical records and, if necessary, by contacting GPs.
  
  
  RESULTS
  We collected 173 prescriptions. Fifty-six (32%) were in accordance with marketing authorization indications and, among them, 15 prescriptions (9% of all) respected the French guidelines about dosage and duration of treatment. One hundred and six prescriptions (61%) were not adequate and among them an off-label use was notified in 91 (53% of all); among them 33% for simple dyspeptic disorders, 23% for the prevention of NSAID-induced lesions in patients without risk factors, and finally 17% for the prevention of stress ulcer. Fifty-two prescriptions (30%) were unclassified due to incomplete data.
  
  
  CONCLUSIONS
  Our study showed that a vast majority of the prescriptions for PPIs are not in accordance with French guidelines. Preventive actions against abusive prescriptions, withdrawal strategies or replacement of already prescribed PPIs should be implemented to reduce the risk of side effects and the economic impact of long term use of PPIs.
authors.affiliation: Service de pharmacie hospitalière, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33075 Bordeaux, France. Electronic address: lucie.sauvaget@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Sauvaget
authors.affiliation: Service de médecine interne (unités 22, 23, 26), hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33075 Bordeaux, France.
authors.forename: L
authors.initials: L
authors.lastname: Rolland
authors.affiliation: Service de pharmacie hospitalière, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33075 Bordeaux, France.
authors.forename: S
authors.initials: S
authors.lastname: Dabadie
authors.affiliation: Service de médecine interne (unités 22, 23, 26), hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33075 Bordeaux, France.
authors.forename: J
authors.initials: J
authors.lastname: Desblaches
authors.affiliation: Service de médecine interne (unités 22, 23, 26), hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33075 Bordeaux, France.
authors.forename: N
authors.initials: N
authors.lastname: Bernard
authors.affiliation: Service de médecine interne (unités 22, 23, 26), hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33075 Bordeaux, France.
authors.forename: M-A
authors.initials: MA
authors.lastname: Vandenhende
authors.affiliation: Service de médecine interne (unités 22, 23, 26), hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33075 Bordeaux, France.
authors.forename: F
authors.initials: F
authors.lastname: Bonnet
authors.affiliation: Service de pharmacie hospitalière, hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33075 Bordeaux, France.
authors.forename: S
authors.initials: S
authors.lastname: Pédeboscq
authors.affiliation: Service de médecine interne (unités 22, 23, 26), hôpital Saint-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33075 Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Morlat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France / Q000453:epidemiology; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
chemical_list: D054328:Proton Pump Inhibitors
keywords: Drug utilization review; Effets indésirables; Good clinical practice guidelines; Guide de bonnes pratiques; Inhibiteurs de la pompe à protons; Proton pump inhibitors; Revue des pratiques de prescription des médicaments; Side effects