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Appropriateness of proton pump inhibitors treatment in clinical practice: Prospective evaluation in outpatients and perspective assessment of drug optimisation.
Metadata
Journaldigestive and liver disease3.57Date
2020 Jun 03
4 months ago
Type
Journal Article
Volume
2020-Aug / 52 : 862-868
Author
Giannini EG 1, Crespi M 2, Djahandideh A 2, Demarzo MG 2, Moscatelli A 2, Bodini G 2, Furnari M 2, Marabotto E 2, Plaz Torres MC 2, Zentilin P 2, Savarino V 2
Affiliation
  • 2. Gastroenterology Unit, Department of Internal Medicine, University of Genoa, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
Doi
PMIDMESH
Abstract
BACKGROUND: High rates of inappropriate proton pump inhibitor (PPI) prescriptions have been reported in retrospective database analyses. Assessing the appropriateness of long-term PPIs in outpatients, with a proactive approach at drug optimisation may enhance treatment adequacy.
AIMS: To describe the characteristics of outpatients who are on long-term PPIs, to assess the magnitude of inappropriate PPI prescriptions, and to evaluate the rate of drug optimisation following specialist recommendations.
METHODS: Appropriateness of long-term (>8weeks) PPI prescription was prospectively assessed in 249 consecutive patients referred to a Gastroenterology outpatient clinic. We recorded reason for prescription, dose, modality, duration of therapy, and attempts at PPI optimisation.
RESULTS: PPIs were inappropriately prescribed in 96/249 patients (38.6%). Gastro-oesophageal reflux disease (50/143, 35.0%) and prophylaxis of anti-platelet/non-steroidal anti-inflammatory drugs (5/49, 10.2%) were the most common PPI indications and those with the lowest rate of inappropriateness, while the highest rates were observed for treatment of dyspepsia (10/12, 83.3%) and anti-coagulant therapy (21/21, 100%). PPI treatment was optimised in 112 patients (45.0%).
CONCLUSIONS: PPIs are inappropriately used in about 40% of outpatients, reflecting scant attention to guidelines. A proactive approach may improve therapeutic adequacy in approximately half of patients. Educational efforts to guide PPI prescription should be further pursued.
Keywords: Gastro-oesophageal reflux disease Long-term Outcomes Prescription Proton pump inhibitors
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3.6
Dig Liver Disdigestive and liver disease
Metadata
LocationNetherlands
FromELSEVIER SCIENCE INC

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