Year 2018 / Volume 110 / Number 12
Original
Appropriateness of the use of proton pump inhibitors in the Emergency Department of a Spanish university hospital

755-761

DOI: 10.17235/reed.2018.5468/2018

Beatriz Granero-Melcon, Ignacio Morrás, Miguel Galán-DeJuana, Francisco Abad-Santos,

Abstract
Background: the use of proton pump inhibitors (PPI) has increased substantially during the last years, possibly due to a significant proportion of prescriptions that do not follow the approved indications. Objective: to assess the prevalence of PPI prescription and the appropriateness of the prescription within the Emergency Department (ED) of a Spanish university hospital. Materials and methods: a cross-sectional, retrospective prescription-indication drug-use study was performed, which selected 384 patients that presented to the ED over two days in January 2016. Results: of the total cohort, 23.2% were taking PPI before their hospital visit and only 20.2% had a correct indication and dosage; 2.9% of the patient cohort had an indication for PPI treatment but had not been prescribed them. A drug other than omeprazole was used in 25% of cases; 30.47% of the patients were discharged with a PPI and only 28.2% of them had the correct indication and dosage. Finally, 5.7% were not prescribed PPI even though it was warranted. PPI prescription increased with age whereas the indication for the prescription decreased. Furthermore, the use of these drugs was higher in hospitalized patients compared to discharged patients. Conclusions: these results are in line with similar studies, which demonstrate the existence of an over-prescription of PPI. PPI prescription needs to be improved, thereby reducing drug interactions, adverse effects and unnecessary economical expenses.
Share Button
New comment
Comments
No comments for this article
References
[1] Anonymous. Subgrupos ATC y Principios activos de mayor consumo en el Sistema Nacional de Salud en 2009. Información Terapéutica del Sistema Nacional de Salud 2010; 35(4):124-8. Available from: http://mspsi.gob.es/en/biblioPublic/publicaciones/recursos_propios/infMedic/docs/vol33_2Antiulcerosos.pdf
[2] Spanish Agency of Medicines and Health Products. Utilización de medicamentos antiulcerosos en España durante el período 2000-2012. Informe de utilización de medicamentos U/AUL/V1/15012014. Jan 2014. Available from: https://www.aemps.gob.es/medicamentosUsoHumano/observatorio/docs/antiulcerosos.pdf
[3] Barrera E, Gomez E, Mataix A, et al. Grupo de Recomendaciones en Farmacoterapia de la Comunidad de Madrid. Criterios de selección de Inhibidores de la Bomba de Protones, Consejería de Sanidad, Servicio Madrileño de Salud, 2011. Available from: http://www.madrid.org/cs/Satellite?blobcol=urldata&blobheader=application/pdf&blobheadername1=Content-Disposition&blobheadervalue1=filename%3DN3_01_2012.PDF&blobkey=id&blobtable=MungoBlobs&blobwhere=1352883657847&ssbinary=true
[4] García J. Estudio de utilización de antiulcerosos en España (2000-2008). Inf Ter Sist Nac Salud 2009; 33(2):49-54. Available from: http://mspsi.gob.es/en/biblioPublic/publicaciones/recursos_propios/infMedic/docs/vol33_2Antiulcerosos.pdf
[5] Agirrezabala JR, Aizpurua I, Albizuri M, et al.. Inhibidores de la bomba de protones ¿se puede vivir sin ellos? Información Farmacoterapéutica de la Comarca, Centro Vasco de Información de Medicamentos CEVIME / MIEZ 2010; 18(3):11-16. Available from: http://www.euskadi.eus/contenidos/informacion/cevime_infac_2010/es_def/adjuntos/infac_v18_n9.pdf
[6] Aguilera-Castro L, Martín-de-Argila-de-Prados C, Albillos-Martínez A. Practical considerations in the management of proton-pump inhibitors. Rev Esp Enferm Dig 2016;108:145-153
[7] Spanish Agency of Medicines and Health Products. Drug labels of omeprazole, lansoprazole, rabeprazole, pantoprazole and esomeprazole. Available from: http://www.aemps.gob.es/cima/fichasTecnicas.do?metodo=detalleForm.
[8] Fernandez I, Ochoa D, Prado F, et al. Criterios para la optimización en el uso de fármacos inhibidores de la bomba de protones. PdF 2015; 21(6):85-86. Available from: http://www.madrid.org/cs/Satellite?blobcol=urldata&blobheader=application%2Fpdf&blobheadername1=Content-disposition&blobheadername2=cadena&blobheadervalue1=filename%3DNoviembre-Diciembre+2015.pdf&blobheadervalue2=language%3Des%26site%3DHospitalLaPrincesa&blobkey=id&blobtable=MungoBlobs&blobwhere=1352934429955&ssbinary=true
[9] Bañon N, Montes E, Alonso JM, et al.. Prescripción razonada de IBP. Boletín canario de uso racional del medicamento del Servicio Canario de Salud, Consejería de Sanidad, Servicio Canario de la Salud, 2015. Available from: http://www3.gobiernodecanarias.org/sanidad/scs/content/0bd95e0c-2952-11e5-bfb0-bdcd7104fbae/BOLCAN_Vol7_N1_PRESCRIPCION_RAZONADA_IBP.pdf
[10] Encinas A, Lanas A, Peña E, et al. Guía de la buena práctica clínica en protección gastrointestinal ante la ingesta de fármacos. Ministerio de Sanidad y Consumo, 2007. Available from: https://www.cgcom.es/sites/default/files/GBPC_Proteccion_gastrointestinal.pdf
[11] De Burgos C, Novo S, Llorente E, et al. Estudio de prescripción-indicación de inhibidores de la bomba de protones. Rev Clín Esp 2006; 206(6): 266–70.
[12] Hermida A, Cabana B, Lorenzo V. Prevalencia de prescripción indicación de protectores gástricos en pacientes hospitalizados. Gac Sanit 2007; 21:412-5.
[13] Martin-Echevarría E, Pereira A, Torralba M, et al. Evaluación del uso de los inhibidores de la bomba de protones en un servicio de medicina interna. Rev Esp Enferm Dig 2008;100:76-81.
[14] Reid M, Keinston A, Miller M, et al. Inappropriate prescribing of proton pump inhibitors in hospitalized patients. J Hosp Med 2012;7(5):421-5.
[15] Ramirez E, Lei SH, Borobia AM, et al. Overuse of PPIs in patients at admission, during treatment, and at discharge in a tertiary Spanish hospital. Curr Clin Pharmacol 2010;5(4):288-97.
[16] Mazer-Amirshahi M, Mullins PM, van den Anker J, et al. Rising rates of proton pump inhibitor prescribing in US Emergency Departments. Am J Emerg Med 2014;32(6):618-22.
[17] Sanjose-Rodriguez AI, Velarde-Mayol C, Gomez JA. Variabilidad en la práctica clínica, calidad de prescripción de los inhibidores de la bomba de protones. Rev Calidad Asistencial 2012;27(3):182-3.
[18] Durand C, Willett K, Desilets AR, et al. Proton pump inhibitor use in hospitalized patients: is overutilization becoming a problem? Clin Med Insights: Gastroenterol 2012; 5:65–76.
[19] Forgacs I, Loganayagam A. Overprescribing proton pump inhibitors. BMJ 2008; 336(7634):2-3.
[20] Ahrens D, Behrens G, Himmel W et al. Appropriateness of proton pump inhibitor recommendations at hospital discharge and continuation in primary care. Int J Clin Pract 2012;66:767-73
[21] Gisbert JP, Molina-Infante J, et al. IV Conferencia Espanola de Consenso sobre el tratamiento de la infección por Helicobacter pylori. Gastroenterol Hepatol. 2016. Gastroenterol Hepatol. 2016;39(10):697-721
[22] Ying VW, Kim SH, Khan KJ, et al. Prophylactic PPI help reduce marginal ulcers after gastric bypass surgery: a systematic review and meta-analysis of cohort studies. Surg Endosc 2015;29(5):1018-23.
[23] Gumbs A, Duffy A, Bell R. Incidence and management of marginal ulceration after laparoscopic Roux-Y gastric bypass. Surg Obes Relat Dis 2006; 2(4):460-3.
[24] Madridejos R. Inhibidores de la bomba de protones y el balance riesgo-beneficio. Butlletí d'informació terapèutica. Generalitat de Catalunya, Departament de Salut 2013;24(2):7-11. Available from: http://medicaments.gencat.cat/web/.content/minisite/medicaments/professionals/6_publicacions/butlletins/boletin_informacion_terapeutica/documents/arxius/BIT_v24_n02_cast.pdf
[25] Corleto VD, Festa S, Di Giulio E, et al. Proton pump inhibitor therapy and potential long-term harm. Curr Opin Endocrinol Diabetes Obes 2014; 21(1):3-8.
[26] Johnson DA, Edward C. Oldfield IV. Reported side effects and complications of long-term proton pump inhibitor use. Clin Gastroenterol Hepatol 2013;11(5):458-464.
[27] Heidelbaugh JJ, Metz DC, Yang XY. Proton pump inhibitors: are they overutilised in clinical practice and do they pose significant risk? Int J Clin Pract 2012; 66(6):582–91.
[28] Yachimski PS, Farrell EA, Hunt DP, et al. Proton pump inhibitors for prophylaxis of nosocomial upper gastrointestinal tract bleeding: Effect of standardized guidelines on prescribing practice. Arch Intern Med 2010; 170(9):779–83.
[29] Atkins R, Smith L. Impact of pharmacy intervention on the use of proton-pump inhibitors in the hospital setting. Consult Pharm 2013; 28(12):786-92
Citation tools
Granero-Melcon B, Morrás I, Galán-DeJuana M, Abad-Santos F. Appropriateness of the use of proton pump inhibitors in the Emergency Department of a Spanish university hospital. 5468/2018


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 558 visits.
This article has been downloaded 285 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 14/01/2018

Accepted: 04/10/2018

Online First: 26/10/2018

Published: 03/12/2018

Article revision time: 261 days

Article Online First time: 285 days

Article editing time: 323 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology