AIM: Proton-pump inhibitors (PPI) are extensively prescribed worldwide. However, little information is available on PPI prescribing patterns, associated clinical and demographic factors, and potential drug-drug interactions in frail older patients. METHODS: Data on clinical and demographic characteristics, and full medication exposure were collected in a consecutive series of 361 older patients (age 84 ± 7 years) admitted to two acute geriatric admission units (Aberdeen, National Health Service Grampian) between 1 February 2010 and 30 June 2010. A set of predetermined criteria was used to assess appropriateness of PPI prescribing. RESULTS: PPI were prescribed in 148 patients (41.0%). Inappropriate overprescribing was observed in 127 patients (35.2% of the study population, 85.8% of patients prescribed PPI). PPI were inappropriately not prescribed in 20 patients (48.8% of patients with an indication for PPI treatment). Regression analysis showed that the total number of non-PPI prescribed drugs (OR 1.08; 95%CI 1.01-1.15) and a higher Charlson Comorbidity Index (OR 1.08; 95%CI 1.001-1.16) were independently associated with inappropriate PPI overprescribing. Potential drug-drug interactions were found in 75 patients (22.8% of the study population), mainly in patients with PPI overprescribing. CONCLUSIONS: Inappropriate PPI prescribing is common in frail older hospitalized patients, and might increase the risk of drug-drug interactions. Polypharmacy and comorbidity were independently associated with inappropriate PPI prescribing in this group.
AIM: Proton-pump inhibitors (PPI) are extensively prescribed worldwide. However, little information is available on PPI prescribing patterns, associated clinical and demographic factors, and potential drug-drug interactions in frail older patients. METHODS: Data on clinical and demographic characteristics, and full medication exposure were collected in a consecutive series of 361 older patients (age 84 ± 7 years) admitted to two acute geriatric admission units (Aberdeen, National Health Service Grampian) between 1 February 2010 and 30 June 2010. A set of predetermined criteria was used to assess appropriateness of PPI prescribing. RESULTS: PPI were prescribed in 148 patients (41.0%). Inappropriate overprescribing was observed in 127 patients (35.2% of the study population, 85.8% of patients prescribed PPI). PPI were inappropriately not prescribed in 20 patients (48.8% of patients with an indication for PPI treatment). Regression analysis showed that the total number of non-PPI prescribed drugs (OR 1.08; 95%CI 1.01-1.15) and a higher Charlson Comorbidity Index (OR 1.08; 95%CI 1.001-1.16) were independently associated with inappropriate PPI overprescribing. Potential drug-drug interactions were found in 75 patients (22.8% of the study population), mainly in patients with PPI overprescribing. CONCLUSIONS: Inappropriate PPI prescribing is common in frail older hospitalized patients, and might increase the risk of drug-drug interactions. Polypharmacy and comorbidity were independently associated with inappropriate PPI prescribing in this group.
Authors: R Schepisi; S Fusco; F Sganga; B Falcone; D L Vetrano; A Abbatecola; F Corica; M Maggio; C Ruggiero; P Fabbietti; A Corsonello; G Onder; F Lattanzio Journal: J Nutr Health Aging Date: 2016 Impact factor: 4.075
Authors: Jan Zirk-Sadowski; Jane A Masoli; Joao Delgado; Willie Hamilton; W David Strain; William Henley; David Melzer; Alessandro Ble Journal: J Am Geriatr Soc Date: 2018-04-20 Impact factor: 5.562
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Authors: Anne Delcher; Sylvie Hily; Anne Sophie Boureau; Guillaume Chapelet; Gilles Berrut; Laure de Decker Journal: PLoS One Date: 2015-11-04 Impact factor: 3.240