OBJECTIVES: To evaluate the adaptation of Proton Pump Inhibitors (PPI) prescriptions to the indications in the literature. To determine which doctors, patients and prescriptions characteristics are related to a correct prescription and to measure their relative importance. MATERIAL AND METHODS: Cross-sectional observational study of prescription indication in an Urban Primary Care Center. Simple Random Sampling was used from primary care center patients PPIs prescriptions between July and December of 2003. Non-electronic prescriptions (OMI-AP program) were excluded from the sample. 412 PPI prescriptions were necessary as sample size to obtain a 95% confidence with a 4.7% precision and a 50% expected proportion. Simple random sampling techniques were used. RESULTS: Prescription was correct under adequacy criteria in 36.4% of the cases. The effect of the "hiatal hernia" and "user activity status" variables showed the major impact on results with an OR: 0.361 and 1.672 respectively. NSAID treated patients PPIs prescriptions matched adequacy criteria in 79.5% of the cases. "Prescription source" and "User activity status" variables gave the highest impact with an OR: 2.5 and 4.52, respectively. CONCLUSIONS: The high percentage of non-adequate prescriptions together with the differences found between primary and specialized levels of attention, could suggest lack of knowledge of PPIs prophylactic indications and lack of coordination between different levels of attention that could be solved by creating common performing protocols.
OBJECTIVES: To evaluate the adaptation of Proton Pump Inhibitors (PPI) prescriptions to the indications in the literature. To determine which doctors, patients and prescriptions characteristics are related to a correct prescription and to measure their relative importance. MATERIAL AND METHODS: Cross-sectional observational study of prescription indication in an Urban Primary Care Center. Simple Random Sampling was used from primary care center patients PPIs prescriptions between July and December of 2003. Non-electronic prescriptions (OMI-AP program) were excluded from the sample. 412 PPI prescriptions were necessary as sample size to obtain a 95% confidence with a 4.7% precision and a 50% expected proportion. Simple random sampling techniques were used. RESULTS: Prescription was correct under adequacy criteria in 36.4% of the cases. The effect of the "hiatal hernia" and "user activity status" variables showed the major impact on results with an OR: 0.361 and 1.672 respectively. NSAID treated patients PPIs prescriptions matched adequacy criteria in 79.5% of the cases. "Prescription source" and "User activity status" variables gave the highest impact with an OR: 2.5 and 4.52, respectively. CONCLUSIONS: The high percentage of non-adequate prescriptions together with the differences found between primary and specialized levels of attention, could suggest lack of knowledge of PPIs prophylactic indications and lack of coordination between different levels of attention that could be solved by creating common performing protocols.
Authors: Miguel Santibañez Margüello; Roberto Garrastazu; Mario Ruiz-Nuñez; Jose Manuel Helguera; Sandra Arenal; Cristina Bonnardeux; Carlos León; Marc Miravitlles; Juan Luis García-Rivero Journal: NPJ Prim Care Respir Med Date: 2016-09-08 Impact factor: 2.871