Please use this identifier to cite or link to this item: https://doi.org/10.4066/AMJ.2014.2093
Title: Proton pump inhibitors: Are we still prescribing them without valid indications?
Authors: Akram, F 
Huang, Y
Lim, V
Huggan, P.J
Merchant, R.A 
Keywords: acetylsalicylic acid
esomeprazole
heparin
lansoprazole
omeprazole
proton pump inhibitor
warfarin
aged
Article
drug indication
duodenum ulcer
female
gastritis
gastroesophageal reflux
gastrointestinal hemorrhage
Helicobacter infection
human
inappropriate prescribing
low drug dose
major clinical study
male
peptic ulcer
prescription
prevalence
retrospective study
Singapore
Issue Date: 2014
Citation: Akram, F, Huang, Y, Lim, V, Huggan, P.J, Merchant, R.A (2014). Proton pump inhibitors: Are we still prescribing them without valid indications?. Australasian Medical Journal 7 (11) : 465-470. ScholarBank@NUS Repository. https://doi.org/10.4066/AMJ.2014.2093
Abstract: Background Evidence from several Western studies has shown an alarmingly high and inappropriate rate of prescription of proton pump inhibitors (PPIs), which may be associated with increased healthcare costs and adverse outcomes. PPI prescribing patterns remain largely unknown in well-developed healthcare systems in Southeast Asia.Aims We aimed to determine the prevalence of inappropriate prescription of PPI among elderly patients without documentation of valid indications, in a tertiary teaching hospital in Singapore.Methods We carried out a retrospective clinical records review of 150 elderly patients aged ?65 years that had been admitted to two internal medicine wards between 25 May 2011 and 28 June 2011 to determine the appropriateness of indications for PPIs prescribed at hospital discharge. PPI indications were categorised as “valid”, “likely invalid”, and “probable” based on current clinical literature. Pre-admission and discharge prescriptions were reviewed to determine continuation of pre-admission and new PPI prescriptions at discharge. Data on clinical characteristics and concurrent use of ulcerogenic medications were collected.Results From a total of 150 patients, 80 (53 per cent) received prescriptions for PPIs. Of these, 65 (81.2 per cent) had no valid documented indications (i.e., the indication was classed as “likely invalid”); 10 (12.5 per cent) had valid indications; and in five cases (6.2 per cent) the indication was “probable”. The most common “likely invalid” indication was primary gastrointestinal bleeding prophylaxis (GIP) among low-dose aspirin users in 28 patients (43 per cent) of invalid PPI prescriptions.Conclusion Inappropriate prescribing of PPIs without documented valid indications was prevalent among elderly patients at our tertiary teaching hospital in Singapore, providing evidence that shows a similar trend to PPI prescribing to data from Western countries. © 2014, Australasian Medical Journal Pty Ltd. All right reserved.
Source Title: Australasian Medical Journal
URI: https://scholarbank.nus.edu.sg/handle/10635/174161
ISSN: 18361935
DOI: 10.4066/AMJ.2014.2093
Appears in Collections:Elements
Staff Publications

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
10_4066_AMJ_2014_2093.pdf714.88 kBAdobe PDF

OPEN

NoneView/Download

SCOPUSTM   
Citations

15
checked on Jul 21, 2021

Page view(s)

85
checked on Jul 23, 2021

Download(s)

2
checked on Jul 23, 2021

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.