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General and Risk Management, Patient Safety (including: medication errors, quality control)
Prescription of prophylactic proton pump inhibitors at hospital discharge
  1. A. Escudero,
  2. N. El Hiali,
  3. N. Pi,
  4. E. Ramió,
  5. G.I. Ballesteros,
  6. M. Aguas,
  7. M. Pons,
  8. B. Eguileor
  1. 1Capio Hospital Universitari Sagrat Cor, Pharmacy, Barcelona, Spain

Abstract

Background Proton pump inhibitors (PPIs) are used in the treatment of conditions such as dyspepsia, gastro-oesophageal reflux disease and Zollinger-Ellison syndrome. They are also used in the prevention of peptic ulcer disease (stomach ulcers) or haemorrhage induced by non-steroidal anti-inflammatory drugs or antiplatelet agents, in patients with additional criteria. The literature refers to an overuse of PPI in patients who do not match these indications.

Purpose To evaluate PPI prescriptions at discharge from our hospital (a tertiary hospital).

Materials and methods The authors carried out a cross-sectional observational study in a tertiary care hospital located in Barcelona. The study included patients older than 18 years discharged during the months of July and August 2011. The authors excluded patients whose PPI treatment was justified. The authors included patients with preventive prescriptions for PPIs, patients without any PPI prescription at discharge and patients with another antacid at discharge. The authors calculated the percentage of patients who met the criteria for preventive PPI prescription but for whom it was not prescribed at discharge, and likewise the percentage of patients with an appropriate preventive prescription of PPI at discharge.

Results The authors included 96 patients, seven were excluded because the PPI prescription fitted the indication for PPI treatment. The 89 patients included had a mean age of 77.48 years (SD 13.57). 59.6% of these had a PPI prescribed at discharge (average age of 79.92 years (SD 11.45) and 50.9% were women). 37.1% of patients did not have a PPI prescription at discharge and 3.4% were prescribed other antacids. These two groups made a total of 36 patients, five of whom met criteria for PPI preventive prescription (13.9%). Of the patients who were prescribed a PPI at discharge, only 17 (32.1%) met criteria for preventive PPI prescription.

Conclusions The prescription of PPI at discharge for patients who do not meet the criteria for prevention of stomach disorders is a noticeable problem in our hospital.

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