Erik Puchon1, Maria Goboova2, Ivan Vano2, Tomas Fazekas3, Zuzana Javorova-Rihova1,4, Magdalena Kuzelova5. 1. Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, Kalinciakova 8, 832 32, Bratislava, Slovak Republic. 2. Department of Internal Medicine, Teaching Hospital Nitra, Spitalska 6, 950 01, Nitra, Slovak Republic. 3. Department of Physical Chemistry of Drugs, Faculty of Pharmacy, Comenius University in Bratislava, Odbojarov 10, 832 32, Bratislava, Slovak Republic. 4. Department of Clinical Pharmacology, Teaching Hospital Trnava, A. Zarnova 11, 917 75, Trnava, Slovak Republic. 5. Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, Kalinciakova 8, 832 32, Bratislava, Slovak Republic. kuzelova@fpharm.uniba.sk.
Abstract
PURPOSE: To investigate the relationship between medications with a known risk of gastrointestinal bleeding and proton pump inhibitor (PPI) prescription not according to guidelines. METHODS: An analysis of the records of 592 hospitalised patients aged 65 years or older was undertaken. The number of all medicines, potentially inappropriate medicines according to the EU(7)-PIM list and the Beers Criteria 2019 and medicines with a known risk of gastrointestinal bleeding, was compared in patients with PPI prescription not given based on guidelines and in patients with no PPI prescription. RESULTS: Patients prescribed PPI not based on guidelines used more medications on average (9.6 vs. 6.4, p < 0.001), more PIMs according to the EU(7)-PIM list (2.4 vs. 1.1, p < 0.001) and the Beers criteria (2.0 vs. 0.6, p < 0.001) at hospital admission and at discharge (8.9 vs. 7.5, p < 0.001, mean number of medications), (2.0 vs. 1.2, p < 0.001, EU(7)-PIM list), (1.9 vs. 0.8, p < 0.001, Beers criteria) than patients with no PPI prescription. Patients prescribed PPI not according to guidelines were more frequently using direct oral anticoagulants (28% vs. 12.8%, p < 0.001), corticosteroids (5.3% vs. 0.7%, p = 0.025) at hospital admission and at discharge (25.9% vs. 16.5%, p = 0.018, oral anticoagulants), (6.6% vs. 1%, p = 0.006, corticosteroids), (13.3% vs. 5.4%, p = 0.004, warfarin) than patients with no PPI prescription. CONCLUSION: The number of medications, potentially inappropriate medications according to the EU(7)-PIM list and Beers criteria, and the use of direct oral anticoagulants, warfarin and corticosteroid prescriptions were the medication-related factors associated with PPI prescription not according to guidelines in elderly patients.
PURPOSE: To investigate the relationship between medications with a known risk of gastrointestinal bleeding and proton pump inhibitor (PPI) prescription not according to guidelines. METHODS: An analysis of the records of 592 hospitalised patients aged 65 years or older was undertaken. The number of all medicines, potentially inappropriate medicines according to the EU(7)-PIM list and the Beers Criteria 2019 and medicines with a known risk of gastrointestinal bleeding, was compared in patients with PPI prescription not given based on guidelines and in patients with no PPI prescription. RESULTS:Patients prescribed PPI not based on guidelines used more medications on average (9.6 vs. 6.4, p < 0.001), more PIMs according to the EU(7)-PIM list (2.4 vs. 1.1, p < 0.001) and the Beers criteria (2.0 vs. 0.6, p < 0.001) at hospital admission and at discharge (8.9 vs. 7.5, p < 0.001, mean number of medications), (2.0 vs. 1.2, p < 0.001, EU(7)-PIM list), (1.9 vs. 0.8, p < 0.001, Beers criteria) than patients with no PPI prescription. Patients prescribed PPI not according to guidelines were more frequently using direct oral anticoagulants (28% vs. 12.8%, p < 0.001), corticosteroids (5.3% vs. 0.7%, p = 0.025) at hospital admission and at discharge (25.9% vs. 16.5%, p = 0.018, oral anticoagulants), (6.6% vs. 1%, p = 0.006, corticosteroids), (13.3% vs. 5.4%, p = 0.004, warfarin) than patients with no PPI prescription. CONCLUSION: The number of medications, potentially inappropriate medications according to the EU(7)-PIM list and Beers criteria, and the use of direct oral anticoagulants, warfarin and corticosteroid prescriptions were the medication-related factors associated with PPI prescription not according to guidelines in elderly patients.
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
Authors: Gene R Quinn; Anne S Hellkamp; Graeme J Hankey; Richard C Becker; Scott D Berkowitz; Günter Breithardt; Maurizio Fava; Keith A A Fox; Jonathan L Halperin; Kenneth W Mahaffey; Christopher C Nessel; Manesh R Patel; Jonathan P Piccini; Daniel E Singer Journal: J Am Heart Assoc Date: 2018-08-07 Impact factor: 5.501