title: Prevalence and predictors of non-evidence based proton pump inhibitor use among elderly nursing home residents in the US.
abstract: Proton pump inhibitors (PPIs) can lead to several adverse effects among the elderly, particularly when used inappropriately or in contrast to evidence suggested protocols.
  
  
  
  The aim of this study was to examine the prevalence and predictors of non-evidence based PPI use in elderly nursing home residents.
  
  
  
  A cross-sectional study was conducted using data from the 2004 National Nursing Home Survey (NNHS). The study sample included nursing home residents 65 years and older. Descriptive statistics were used to examine the prevalence of non-evidence based PPI use. Multivariable logistic regression was used to evaluate the patient and facility-level factors associated with non-evidence based PPI use among the elderly nursing home residents.
  
  
  
  A total of 355,600 elderly nursing home residents received at least one PPI for an overall prevalence of 26.99%. Among those elderly receiving PPIs, 48.59% of the use was not evidence based. Multivariable logistic regression revealed that residents with osteoporosis (Odds Ratio (OR): 0.55, 95% CI: 0.45-0.68), SSRI users (OR: 0.81, 95% CI: 0.68-0.97) and those residing in micropolitan area (OR: 0.79, 95% CI: 0.63-0.98) were negatively associated with prescription of PPIs without an indication. Patients with chronic cough (OR: 2.10, 95% CI: 1.12-3.96) and Medicare insurance (OR: 1.23, 95% CI: 1.01-1.50) were positively associated with prescription of PPIs without an indication.
  
  
  
  The current study found that almost half of the elderly nursing home residents used PPIs for non-evidence based indications. Given the safety concerns and high non-evidence based use of PPIs in nursing homes, there is an urgent need to optimize PPI use in the elderly.
authors.affiliation: Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, 1441 Moursund St., Houston, TX, USA.
authors.forename: Pratik P
authors.initials: PP
authors.lastname: Rane
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Sushovan
authors.initials: S
authors.lastname: Guha
authors.affiliation: Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, 1441 Moursund St., Houston, TX, USA; Health Economics and Outcomes Research, Novartis Healthcare Pvt. Ltd., Hyderabad, India.
authors.forename: Satabdi
authors.initials: S
authors.lastname: Chatterjee
authors.affiliation: Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, 1441 Moursund St., Houston, TX, USA. Electronic address: raparasu@central.uh.edu.
authors.forename: Rajender R
authors.initials: RR
authors.lastname: Aparasu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D019317:Evidence-Based Medicine; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D054328:Proton Pump Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D014481:United States
chemical_list: D054328:Proton Pump Inhibitors
keywords: Elderly; Indication; Nursing home; Proton pump inhibitor