Background and importance The use of proton pump inhibitors (PPIs) has increased considerably in recent years, probably due to their prescription in unjustified clinical situations or their prolonged maintenance without prescription revision, which can expose the patient to adverse effects.
Aim and objectives To determine the prevalence of PPI prescriptions without a clear indication in elderly patients institutionalised in a geriatric healthcare centre (GHC) that would require their deprescription assessment, as well as to quantify the prevalence of fractures in these patients.
Material and methods An observational, descriptive, cross sectional study was conducted in all institutionalised patients in a GHC associated with a tertiary hospital in May 2020. The variables collected were: sex, age, PPI prescription, indication, duration of PPI treatment, number of drugs prescribed, concomitant prescription of a gastrolesive drug and bisphosphonates, history of upper gastrointestinal bleeding or gastroduodenal ulcer, and history of fracture. Suitable indications for a PPI were those included on the label.
Results GHC is a 120 bed residence with 95 patients. 73.7% were women and mean age was 82.3±8.3 years. At the date of the study, 78 patients (82.1%) were being treated with a PPI, of which a clear indication according to label was found in 51.3%. The prescribed PPIs were: omeprazole 20 mg in 96.2%, lansoprazole 15 mg in 1.3% and lansoprazole 30 mg in 2.6%. At least 41% of the patients had been treated with PPIs for more than a year; for the rest of the patients, no prescription data were available prior to joining the pharmacy service. The mean number of drugs prescribed per patient was 8.3±5, 1.2% were being treated with an NSAID, 42.3% were taking acetylsalicylic acid concomitantly at antiplatelet doses and 3.8% were given bisphosphonates. The prevalence of patients being treated with a PPI and with a history of fracture was 48.7%.
Conclusion and relevance There was a high prevalence of patients without a clear indication for the prescription of PPIs in the GHC. This makes it necessary to review the treatments to assess possible deprescription of these drugs. In addition, their administration could be related to an increased risk of fractures due to its high prevalence.
Conflict of interest No conflict of interest
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