Snapshot of proton pump inhibitors prescriptions in a tertiary care hospital in Switzerland: less is more?

• DOI: 10.1007/s11096-019-00929-w
• Publication Date: 2019-10-30T20:27:03Z
• Authors: Camille Lenoir; Myriam El Biali; Christophe Luthy; Olivier Grosgurin; Jules Alexandre D...; Victoria Rollason
• Keywords: ddc:616; Male; ddc:617; Dose-Response Relationship, Drug; Inappropriate Prescribing; Proton Pump Inhibitors; info:eu-repo/classification/ddc/618.97; Middle Aged; 3. Good health; Hospitals, University; Tertiary Care Centers; 03 medical and health sciences; Cross-Sectional Studies; 0302 clinical medicine; info:eu-repo/classification/ddc/616; ddc:618.97; info:eu-repo/classification/ddc/617; Practice Guidelines as Topic; Humans; Female; Practice Patterns, Physicians'; Switzerland; Aged

AbstractBackgroundProton pump inhibitors are among the most widely prescribed drugs in the world, but more than half of the indications for prescription are unjustified. The misuse of this therapeutic class has heavy consequences such as additional health costs, adverse drug reactions following long-term use and gastric acid rebound when the proton pump inhibitor is discontinued.ObjectiveThe overprescription of proton pump inhibitors is therefore becoming a public health problem, which led us to evaluate their use within the Geneva University Hospitals.SettingPatients hospitalized in two divisions of the department of internal medicine of the Geneva University Hospitals on a single day.MethodsThis is a register-based cross-sectional study and it collected data about the prescription pattern of proton pump inhibitors by consulting the electronic records of patients included.Main outcome measureTo determine if the proton pump inhibitors prescription is made according to the market authorization and the available guidelines.ResultsHundred-eighty patients were included. 54% of patients were on proton pump inhibitors, 29% of whom had their treatment initiated at hospital. Of the indications for treatment, 72% were not justified and 63% of the justified indications did not have an adequate dosage. Therefore, in all patients with a proton pump inhibitor at hospital, only 11% had a justified indication with an adequate dose. Finally, 87% of known home prescriptions were renewed on admission and among them, 71% did not have a justified or possibly justified indication according to the guidelines.ConclusionIndication for treatment inside the hospital was not justified in 72% of patients and only 11% had a justified indication with an adequate dosage. Precise guidelines with evidence-based indications and adequate daily doses would help to correctly prescribe proton pump inhibitors. Moreover, patients should benefit from a thorough evaluation of their treatment.