Mélanie Dipanda1, Laureline Pioro1, Maxime Buttard1, Philippe d'Athis2, Sanaa Asgassou1, Sophie Putot1, Martha Deïdda1, Caroline Laborde1, Alain Putot1, Patrick Manckoundia3. 1. Pôle personnes âgées, hôpital de Champmaillot, CHU, 2, rue Jules-Violle, BP 87909, 21079 Dijon cedex, France. 2. Département d'information médicale, hôpital François-Mitterrand, CHU, 21079 Dijon cedex, France. 3. Pôle personnes âgées, hôpital de Champmaillot, CHU, 2, rue Jules-Violle, BP 87909, 21079 Dijon cedex, France; UMR Inserm/U1093 cognition, action, plasticité sensorimotrice, université de Bourgogne Franche-Comté, 21078 Dijon, France. Electronic address: patrick.manckoundia@chu-dijon.fr.
Abstract
INTRODUCTION AND OBJECTIVES: Proton pump inhibitors (PPI) are widely prescribed in France and could be responsible for adverse drug reactions especially in elderly persons (EP). In order to reduce the misuse of PPI and the excess cost to the Social Security Agency, the French health authorities (Haute Autorité de santé [HAS]) have published strict guidelines for their prescription. We conducted a study in EP to determine the proportion of PPI prescriptions outside HAS guidelines. METHOD: This was a prospective, single-centre observational study in persons aged≥75 years admitted to a geriatric acute-care unit over a period of 6months. The prevalence of prescriptions for PPI and the proportion of prescriptions outside the guidelines were calculated. The sociodemographic and medical characteristics of EP treated with PPI were studied as were the reasons for the prescription of PPI. RESULTS: Among the 818 patients hospitalized during the study period, 270 were taking PPI on admission (33%). Among these prescriptions, 60% were outside the HAS guidelines. Gastro-oesophageal reflux was the leading indication for PPI (30%), followed by dyspepsia (19%). CONCLUSION: This study confirms the high prevalence of prescriptions for PPI and their misuse. As these drugs are apparently well tolerated, prescriptions are often renewed with no medical re-evaluation.
INTRODUCTION AND OBJECTIVES: Proton pump inhibitors (PPI) are widely prescribed in France and could be responsible for adverse drug reactions especially in elderly persons (EP). In order to reduce the misuse of PPI and the excess cost to the Social Security Agency, the French health authorities (Haute Autorité de santé [HAS]) have published strict guidelines for their prescription. We conducted a study in EP to determine the proportion of PPI prescriptions outside HAS guidelines. METHOD: This was a prospective, single-centre observational study in persons aged≥75 years admitted to a geriatric acute-care unit over a period of 6months. The prevalence of prescriptions for PPI and the proportion of prescriptions outside the guidelines were calculated. The sociodemographic and medical characteristics of EP treated with PPI were studied as were the reasons for the prescription of PPI. RESULTS: Among the 818 patients hospitalized during the study period, 270 were taking PPI on admission (33%). Among these prescriptions, 60% were outside the HAS guidelines. Gastro-oesophageal reflux was the leading indication for PPI (30%), followed by dyspepsia (19%). CONCLUSION: This study confirms the high prevalence of prescriptions for PPI and their misuse. As these drugs are apparently well tolerated, prescriptions are often renewed with no medical re-evaluation.
Authors: Caroline Laborde; Jérémy Barben; Anca-Maria Mihai; Valentine Nuss; Jérémie Vovelle; Philippe d'Athis; Pierre Jouanny; Alain Putot; Patrick Manckoundia Journal: Int J Environ Res Public Health Date: 2020-06-24 Impact factor: 3.390