Liu Pengpeng, Li Guangyao, Wu Qian, Han Mei
Department of Pharmacy, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Front Pharmacol. 2024 Sep 4;15:1418086. doi: 10.3389/fphar.2024.1418086. eCollection 2024.
The actual situation and influencing factors of prophylactic use of proton pump inhibitors (PPIs) in internal medicine inpatients receiving glucocorticoid therapy are rarely reported. This study aimed to investigate the current status and influencing factors of prophylactic use of PPIs in internal medicine inpatients receiving glucocorticoid therapy to provide a basis for rational prophylactic use of PPIs.
Internal medicine inpatients receiving glucocorticoid therapy from February 2023 to September 2023 were included. Information on the prophylactic use of PPIs was collected and analyzed by clinical pharmacists. Associated factors with prophylactic use of PPIs were analyzed by univariable and multivariable logistic regression.
980 inpatients were finally included in our study, of which 271 (27.7%) inpatients received prophylactic use of PPIs. Among the inpatients prescribed PPIs, 90 inpatients received a standard dose of PPIs twice a day. Multiple logistic regression analysis showed that age ≥80 years [OR = 7.009, 95% CI (1.424, 34.495), = 0.017], history of gastroesophageal reflux disease (GERD) [OR = 2.047, 95% CI (1.338, 3.133), = 0.001], low platelet count [OR = 0.997, 95% CI (0.994, 0.999), = 0.004], number of concomitant diseases [OR = 1.104, 95% CI (1.056, 1.153), < 0.001], junior doctors [OR = 1.755, 95% CI (1.248, 2.468), = 0.001], glucocorticoid dose (higher than 50 mg, measured by methylprednisolone) [OR = 2.455, 95% CI (1.371, 4.395), = 0.003], antiplatelet agents [OR = 2.567, 95% CI (1.456, 4.524), = 0.001], immunosuppressants [OR = 1.477, 95% CI (1.014, 2.153), = 0.042], and betahistine [OR = 5.503, 95% CI (1.124, 26.950), = 0.035] were associated with more prophylactic use of PPIs.
The prophylactic use of PPIs in internal medicine inpatients receiving glucocorticoid therapy is common in China. Clinical pharmacists will take targeted measures to promote the rational use of PPIs according to the results of this study.
接受糖皮质激素治疗的内科住院患者预防性使用质子泵抑制剂（PPIs）的实际情况及影响因素鲜有报道。本研究旨在调查接受糖皮质激素治疗的内科住院患者预防性使用PPIs的现状及影响因素，为PPIs的合理预防性使用提供依据。
纳入2023年2月至2023年9月接受糖皮质激素治疗的内科住院患者。临床药师收集并分析PPIs预防性使用的信息。通过单因素和多因素逻辑回归分析PPIs预防性使用的相关因素。
最终980例住院患者纳入本研究，其中271例（27.7%）住院患者接受了PPIs预防性使用。在开具PPIs的住院患者中，90例住院患者接受标准剂量的PPIs每日两次。多因素逻辑回归分析显示，年龄≥80岁[比值比（OR）=7.009，95%置信区间（CI）（1.424，34.495），P=0.017]、胃食管反流病（GERD）病史[OR=2.047，95%CI（1.338，3.133），P=0.001]、血小板计数低[OR=0.997，95%CI（0.994，0.999），P=0.004]、合并疾病数量[OR=1.104，95%CI（1.056，1.153），P<0.001]、低年资医生[OR=1.755，95%CI（1.248，2.468），P=0.001]、糖皮质激素剂量（以甲泼尼龙计高于50mg）[OR=2.455，95%CI（1.371，4.395），P=0.003]、抗血小板药物[OR=2.567，95%CI（1.456，4.524），P=0.001]、免疫抑制剂[OR=1.477，95%CI（1.014，2.153），P=0.042]和倍他司汀[OR=5.503，95%CI（1.124，26.950），P=0.035]与更多的PPIs预防性使用相关。
在中国，接受糖皮质激素治疗的内科住院患者预防性使用PPIs很常见。临床药师将根据本研究结果采取针对性措施促进PPIs的合理使用。
