Mohzari Yahya Ali, Alsaegh Ahmed, Basheeruddin Asdaq Syed Mohammed, Al Shanawani Sulafah N, Albraiki Amani A, Bagalb Amal
Department of Clinical Pharmacy, KSMC, Riyadh, Saudi Arabia.
Department of Pharmacology, College of Pharmacy, Al-Maarefa University, Riyadh, Saudi Arabia.
J Res Pharm Pract. 2020 Oct 8;9(3):151-154. doi: 10.4103/jrpp.JRPP_20_62. eCollection 2020 Jul-Sep.
This study was designed to evaluate the extent of inappropriate utilization of intravenous proton-pump inhibitors (IV-PPIs) and its financial burden in a Middle Eastern tertiary care university hospital.
This was an observational, retrospective, cross-sectional study carried out in King Saud University Medical City, Riyadh, Saudi Arabia. During a study period of 6 consecutive weeks, all hospitalized adult patients (age ≥18) who received IV-PPI selected and mapped with their indications. The patient indications analyzed in comparison with the appropriate indications developed based on the evidence from published literature and guidelines.
A total of 347 patients were identified, with a mean age of 51.5 years, of which 51.9% were male. Of all the patients who received IV-PPIs, 251 (72.3%), 66 (19%), and 30 (8.7%) received for stress ulcer prophylaxis (SUP), peptic ulcer disease (PUD) or gastroesophageal reflux diseases (GERDs), and upper gastrointestinal bleeding, respectively. Overall, only 110 (31.7%) of the 347 patients received IV-PPIs appropriately. The patients with SUP showed the highest percentage of inappropriate use of IV-PPI (80.59%) compared to PUD/GERD (19%). The total cost of inappropriate prescription of IV-PPI was 585,167 Saudi Riyal (SAR) (156,044 USD).
There is a high tendency of IV-PPI's inappropriate prescription in our hospital setting. This large-scale inappropriate prescription of IV-PPI in the hospital setting not only may lead to increased financial burden but also expose patients to number of undesired effects.
本研究旨在评估中东地区一家三级医疗大学医院静脉注射质子泵抑制剂（IV-PPIs）的不合理使用程度及其经济负担。
这是一项在沙特阿拉伯利雅得国王沙特大学医学城进行的观察性、回顾性横断面研究。在连续6周的研究期间，选取所有接受IV-PPI治疗的成年住院患者（年龄≥18岁），并根据其用药指征进行分类。将患者的用药指征与基于已发表文献和指南证据制定的合理指征进行比较分析。
共确定了347例患者，平均年龄为51.5岁，其中51.9%为男性。在所有接受IV-PPIs治疗的患者中，分别有251例（72.3%）、66例（19%）和30例（8.7%）接受治疗的指征为应激性溃疡预防（SUP）、消化性溃疡疾病（PUD）或胃食管反流病（GERDs）以及上消化道出血。总体而言，347例患者中只有110例（31.7%）接受IV-PPIs的用药指征合理。与PUD/GERD（19%）相比，SUP患者中IV-PPI使用不当的比例最高（80.59%）。IV-PPI不合理处方的总成本为585,167沙特里亚尔（SAR）（156,044美元）。
在我院环境中，IV-PPI存在较高的不合理处方倾向。医院环境中这种大规模的IV-PPI不合理处方不仅可能导致经济负担增加，还会使患者面临多种不良影响。
