BACKGROUND: Proton pump inhibitors (PPIs) are commonly overused in hospitalized patients. The objectives of this study were to determine the extent of their inappropriate initiation in patients with low risk for gastrointestinal hemorrhage, factors associated with their continuation on discharge and potential cost of this trend. METHODS: Retrospective examination of patients with low risk for gastrointestinal hemorrhage admitted to a tertiary-care teaching hospital over a 3-month period who received esomeprazole. The following information was collected: age, gender, PPI status (de novo or continued) and admitting diagnoses. Additional information collected from the de novo subgroup included indication for PPI, number of days on PPI and continuation of the drug on discharge. The cost of the medication was obtained from pharmacy records. RESULTS: Four hundred nine patients were admitted during the study period and 204 (49.9%) received PPI de novo. Among these, 155 patients (76%) had an inappropriate indication for PPI. Of these, 62 (40%) patients were continued on PPI on discharge. Older age was a significant predictor of continuation of PPI at discharge. The estimated cost of the inpatient and outpatient inappropriate use of PPI was $12,272 and $59,272, respectively. CONCLUSIONS: PPIs are overused in the majority of hospitalized patients with low risk for gastrointestinal bleeding and this practice gets perpetuated at discharge, especially in older patients. The cost of this phenomenon is alarming.
BACKGROUND: Proton pump inhibitors (PPIs) are commonly overused in hospitalized patients. The objectives of this study were to determine the extent of their inappropriate initiation in patients with low risk for gastrointestinal hemorrhage, factors associated with their continuation on discharge and potential cost of this trend. METHODS: Retrospective examination of patients with low risk for gastrointestinal hemorrhage admitted to a tertiary-care teaching hospital over a 3-month period who received esomeprazole. The following information was collected: age, gender, PPI status (de novo or continued) and admitting diagnoses. Additional information collected from the de novo subgroup included indication for PPI, number of days on PPI and continuation of the drug on discharge. The cost of the medication was obtained from pharmacy records. RESULTS: Four hundred nine patients were admitted during the study period and 204 (49.9%) received PPI de novo. Among these, 155 patients (76%) had an inappropriate indication for PPI. Of these, 62 (40%) patients were continued on PPI on discharge. Older age was a significant predictor of continuation of PPI at discharge. The estimated cost of the inpatient and outpatient inappropriate use of PPI was $12,272 and $59,272, respectively. CONCLUSIONS: PPIs are overused in the majority of hospitalized patients with low risk for gastrointestinal bleeding and this practice gets perpetuated at discharge, especially in older patients. The cost of this phenomenon is alarming.
Authors: Sara Mucherino; Manuela Casula; Federica Galimberti; Ilaria Guarino; Elena Olmastroni; Elena Tragni; Valentina Orlando; Enrica Menditto Journal: Int J Environ Res Public Health Date: 2022-05-31 Impact factor: 4.614
Authors: Anca Trifan; Carol Stanciu; Irina Girleanu; Oana Cristina Stoica; Ana Maria Singeap; Roxana Maxim; Stefan Andrei Chiriac; Alin Ciobica; Lucian Boiculese Journal: World J Gastroenterol Date: 2017-09-21 Impact factor: 5.742
Authors: Chiara Miraglia; Florenzo Moccia; Michele Russo; Serena Scida; Marilisa Franceschi; Pellegrino Crafa; Lorella Franzoni; Antonio Nouvenne; Tiziana Meschi; Gioacchino Leandro; Gian Luigi De' Angelis; Francesco Di Mario Journal: Acta Biomed Date: 2018-12-17
Authors: Óskar Ö Hálfdánarson; Anton Pottegård; Einar S Björnsson; Sigrún H Lund; Margret H Ogmundsdottir; Eiríkur Steingrímsson; Helga M Ogmundsdottir; Helga Zoega Journal: Therap Adv Gastroenterol Date: 2018-05-30 Impact factor: 4.409