Feyza Çelik, MD, Department of Family Medicine, University of Health Sciences, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Cenk Aypak, MD, is Associate Professor, Department of Family Medicine, University of Health Sciences, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Gastroenterol Nurs. 2021;44(2):84-91. doi: 10.1097/SGA.0000000000000500.
Proton pump inhibitors are the commonly prescribed drugs for acid-related disorders. However, many of those prescriptions are inappropriate in inpatient and outpatient settings according to the recommended guidelines. Many studies have been conducted in inpatient clinics, but data about the appropriateness of proton pump inhibitor prescribing in outpatient clinics are scarce. Therefore, the aim of this study was to determine inappropriate proton pump inhibitor prescribing rates among patients admitted to a tertiary hospital family medicine outpatient clinic. A total of 259 patients (median age = 59 years; 72.6% women) were enrolled into the study and 35.9% of them had no proper indications to utilize proton pump inhibitors. Inappropriate proton pump inhibitor usage rate was significantly higher in patients older than 60 years compared with their younger counterparts (62.4% vs. 37.6%; p = .001). The most frequent reason to use a proton pump inhibitor with nonapproved indications was polypharmacy (41.9%). Despite endoscopic evaluation, 41.9% of the patients received a proton pump inhibitor without an approved indication. A significant proportion of nonindicated prescriptions were a consequence of continued prescribing without re-evaluating patients in outpatient clinics. Consideration of proton pump inhibitor indications according to the guidelines in every admission may prevent inappropriate prescriptions.
质子泵抑制剂是常用于治疗酸相关疾病的处方药物。然而,根据推荐的指南,许多在住院和门诊环境下开具的质子泵抑制剂处方并不合适。许多研究都在住院诊所进行,但关于门诊诊所质子泵抑制剂处方是否合适的数据却很少。因此,本研究旨在确定在一家三级医院的家庭医学门诊就诊的患者中质子泵抑制剂处方不合理的比例。共纳入了 259 名患者(中位数年龄=59 岁;72.6%为女性),其中 35.9%的患者没有合理的使用质子泵抑制剂的指征。与年龄较小的患者相比,年龄大于 60 岁的患者使用质子泵抑制剂不合理的比例明显更高(62.4%比 37.6%;p=0.001)。非适应证使用质子泵抑制剂最常见的原因是多种药物合用(41.9%)。尽管进行了内镜评估,仍有 41.9%的患者在无适应证的情况下使用了质子泵抑制剂。在门诊,大量的非适应证处方是由于在未重新评估患者的情况下继续开具处方导致的。在每次就诊时根据指南考虑质子泵抑制剂的适应证可能有助于防止不合理的处方。