Hoteit Mayssaa, Mattar Elham, Allaw Racil, Abou Rached Antoine
Lebanese University, School of Medicine, Hadath, Lebanon.
Middle East J Dig Dis. 2020 Oct;12(4):265-270. doi: 10.34172/mejdd.2020.192.
BACKGROUND Proton pump inhibitors (PPIs) are the most potent gastric agents for most acid-related disorders. Their effectiveness has led to their overutilization, leading to potential risks on patients and significant economic implications. The aim of this study was to determine the frequency of PPI overuse in Lebanon. Hence, the economic impact of this overutilization, if proven to be present, can be inferred. METHODS An epidemiological descriptive cross-sectional study was conducted in pharmacies all around Lebanese governorates over a 1-year period, using questionnaires handed out to 1000 participants coming to buy PPIs. Subjects taking PPIs for inappropriate indications or in inappropriate dosages or durations were considered abusing PPIs. PPIs are indicated for multiple gastric disorders and for prophylaxis of gastrointestinal injury when taking gastro-toxic medications. RESULTS 71.4% of subjects were overusing PPIs. Approximately 25 million US dollars were being wasted annually. Three categories of overuse were inferred (indication, dosage, and duration). Gastro protection was the most common reason for taking PPIs. Demographic variables and doctors' prescriptions did not influence PPI overuse. CONCLUSION PPIs are massively overused in Lebanon, leading to a huge burden on the health care system. Adhering to evidence-based guidelines and educational programs is highly recommended to enhance the quality and efficiency of prescriptions.
背景 质子泵抑制剂(PPIs)是治疗大多数酸相关性疾病最有效的胃药。其有效性导致了它们的过度使用,给患者带来潜在风险,并产生重大经济影响。本研究的目的是确定黎巴嫩质子泵抑制剂过度使用的频率。因此,如果证实存在这种过度使用情况,就可以推断出其经济影响。方法 在黎巴嫩各省的药店进行了一项为期1年的流行病学描述性横断面研究,向1000名前来购买质子泵抑制剂的参与者发放问卷。将因不适当适应症、不适当剂量或疗程而服用质子泵抑制剂的受试者视为滥用质子泵抑制剂。质子泵抑制剂适用于多种胃部疾病以及在服用胃毒性药物时预防胃肠道损伤。结果 71.4%的受试者过度使用质子泵抑制剂。每年约有2500万美元被浪费。推断出三类过度使用情况(适应症、剂量和疗程)。胃保护是服用质子泵抑制剂最常见的原因。人口统计学变量和医生处方并未影响质子泵抑制剂的过度使用。结论 黎巴嫩质子泵抑制剂被大量过度使用,给医疗保健系统带来巨大负担。强烈建议遵循循证指南和开展教育项目,以提高处方的质量和效率。