Background and importance The use of omeprazole has become very frequent in recent years, not being indicated on many occasions, so deprescription is necessary to reduce the possible associated adverse effects.
Aim and objectives Analyse the adequacy of omeprazole treatment in institutionalised elderly patients in a social health centre.
Recommend deprescription or dose reduction in susceptible patients.
Material and methods Review of all patients treated with omeprazole in the social health centre. The data were obtained from the electronic prescription and the medical history. Data collected: age, sex, dose, duration of treatment, indication, concomitant medication and interactions. Risk factors for bleeding were also analysed in patients older than 65 years: potentially gastrolesive drugs: anticoagulants, anti-aggregants, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids and selective serotonin reuptake inhibitors (SSRIs) and a history of peptic ulcer.
The deprescription criteria were: no indication for use, duration of treatment exceeds the technical data sheet, and absence of gastrolesive drugs that justify the association of omeprazole.
The pharmacist’s recommendations were carried out in the electronic prescription program and the analysis of acceptance/rejection of the interventions took place 1 month afterwards.
Results 38 patients were being treated with omeprazole. Mean age was 84 years and 74.4% were women.
45% (17 patients) did not meet the criteria for the use of omeprazole; 16 patients were proposed for deprescription and 1 for minimum dose.
Of the 17 patients, 5 (29.4%) took omeprazole for an indicated use but all exceeded the duration recommended.
Regarding the use of potentially gastrolesive medication: 7 patients (41.2%) were being treated with NSAIDs, 5 (29.4%) with SSRIs and 2 (11.7%) with acenocoumarol, but none of them were being treated with acetylsalicylic acid or with associations of high risk of bleeding, so the use of omeprazole was not justified.
One month later, 35.3% (6/17) of the interventions have been accepted, suppressing omeprazole from treatment in 5 cases and reducing to a minimum dose in 1 case.
Conclusion and relevance Omeprazole is a well-tolerated drug, but when used for prolonged treatment it can cause serious problems, so its evaluation is decisive to correct a possible misuse of the drug. This analysis reveals that 45% of the centre’s patients do not meet the appropriate criteria for the use of omeprazole.
Conflict of interest No conflict of interest