Ikeji Chisom, Williams Anne, Hennawi George, Brandt Nicole J
J Gerontol Nurs. 2019 Oct 1;45(10):9-17. doi: 10.3928/00989134-20190912-03.
The aim of the current study is to describe proton pump inhibitor (PPI) prescribing trends in an older adult population and elucidate perspectives regarding PPI deprescribing. A retrospective chart review and a prospective cross-sectional analysis of provider and patient surveys were conducted. The retrospective chart review identified 107 patients age ≥65 who were prescribed PPI therapy. Nineteen patients on PPI therapy and 74 providers completed surveys regarding their perspectives on PPI deprescribing. PPI therapy was potentially inappropriate for 66% of patients based on dose, duration, and/or indication. Provider barriers to deprescribing included fear of outcomes, access to documentation, and uncertainty of current guidelines. This study illustrates the prevalence of long-term PPI use in geriatric patients without associated clinical indications, as well as perceived barriers to deprescribing. Long-term PPI use is associated with significant side effects; therefore, successful deprescribing must address these perceived barriers. [Journal of Gerontological Nursing, 45(10), 9-17.].
本研究的目的是描述老年人群中质子泵抑制剂(PPI)的处方趋势,并阐明有关PPI减药的观点。我们进行了一项回顾性病历审查以及对医疗服务提供者和患者调查的前瞻性横断面分析。回顾性病历审查确定了107名年龄≥65岁且接受PPI治疗的患者。19名接受PPI治疗的患者和74名医疗服务提供者完成了关于他们对PPI减药观点的调查。基于剂量、疗程和/或适应症,66%的患者使用PPI治疗可能并不恰当。医疗服务提供者在减药方面的障碍包括对结果的担忧、获取文件资料以及当前指南的不确定性。本研究表明老年患者长期使用PPI且无相关临床适应症的情况普遍存在,以及在减药方面存在的认知障碍。长期使用PPI会带来显著的副作用;因此,成功减药必须解决这些认知障碍。[《老年护理杂志》,45(10),9 - 17。]