Inappropriate use of proton pump inhibitors in non-critical indoor patients in a tertiary care teaching hospital in Eastern India
DOI:
https://doi.org/10.18203/2320-6012.ijrms20195913Keywords:
Indoor patients, Intravenous, Once daily, Oral, Proton pump inhibitor, Twice dailyAbstract
Background: Proton pump inhibitors are one of the most commonly used drugs worldwide. Often they are used for inappropriate indications too, imposing economic burden to patients and governments. Many studies have showed equipotent efficacy of oral and intravenous proton pump inhibitor therapy. Despite that, most of the hospitalized patients receive intravenous proton pump inhibitor without appropriate indications. This study aimed to assess use of proton pump inhibitors in government hospital.
Methods: It was an observational cross-sectional study done in the general medicine department of a tertiary care teaching hospital in Eastern India, including 800 noncritical patients. Objective was to assess the use of proton pump inhibitors (indications, route of administration, dosing frequency).
Results: 100% patient received intravenous proton pump inhibitor irrespective of diagnosis. 80% of them received it twice daily and 18% received it once daily. Majority of the patients received intravenous proton pump inhibitor despite taking other drugs by oral route.
Conclusions: Most of the PPI administration was done without appropriate indication. All patients received Intravenous proton pump inhibitors, which may impose economic burden on a government hospital. Majority of the patients received proton pump inhibitors twice daily. These approaches are not cost effective and need to be rectified.
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References
Heidelbaugh JJ, Kim AH, Chang R, Walker PC. Overutilization of proton-pump inhibitors: what the clinician needs to know. Therapeutic advances in gastroenterol. 2012;5(4):219-32.
Hussain S, Stefan M, Visintainer P, Rothberg M. Why do physicians prescribe stress ulcer prophylaxis to general medicine patients?. Southern med J. 2010;103(11):1103.
Thomas L, Culley EJ, Gladowski P, Goff V, Fong J, Marche SM. Longitudinal analysis of the costs associated with inpatient initiation and subsequent outpatient continuation of proton pump inhibitor therapy for stress ulcer prophylaxis in a large managed care organization. J managed care pharm. 2010;16(2):122-9.
Heidelbaugh JJ, Goldberg KL, Inadomi JM. Magnitude and economic effect of overuse of antisecretory therapy in the ambulatory care setting. The Am J managed care. 2010;16(9):e228-34.
Erstad BL, Camamo JM, Miller MJ, Webber AM, Fortune J. Impacting cost and appropriateness of stress ulcer prophylaxis at a university medical center. Critical care med. 1997;25(10):1678-84.
Nasser SC, Nassif JG, Dimassi HI. Clinical and cost impact of intravenous proton pump inhibitor use in non-ICU patients. World J Gastroenterology: WJG. 2010;16(8):982.
Metz DC, Pratha V, Martin P, Paul J, Maton PN, Lew E, Pisegna JR. Oral and intravenous dosage forms of pantoprazole are equivalent in their ability to suppress gastric acid secretion in patients with gastroesophageal reflux disease. The Am J gastroenterol. 2000;95(3):626.
Tringali A, Manta R, Sica M, Bassotti G, Marmo R, Mutignani M. Comparing intravenous and oral proton pump inhibitor therapy for bleeding peptic ulcers following endoscopic management: a systematic review and meta‐analysis. British J clin pharmacol. 2017;83(8):1619-35.
Craig DG, Thimappa R, Anand V, Sebastian S. Inappropriate utilization of intravenous proton pump inhibitors in hospital practice—a prospective study of the extent of the problem and predictive factors. QJM: An Intern J Med. 2010;103(5):327-35.
Zhang H, Yang Z, Ni Z, Shi Y. A meta-analysis and systematic review of the efficacy of twice daily PPIs versus once daily for treatment of gastroesophageal reflux disease. Gastroenterol res practice. 2017;2017.
Tadvi NA, Shareef SM. Use of proton pump inhibitors in general practice: Is it rationale?. Intern J Med Res Health Sci. 2014;3(1):37-42.
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