Unnecessary Prescription of Proton Pump Inhibitors (PPI): An Analysis of Inpatient Discharge Practices

Abstract

Background: Proton pump inhibitors (PPI) have reportedly been used in inappropriate clinical settings, often leading to an increased risk of adverse effects, drug interactions, and costs.

Aim: The aim of this study was to evaluate the appropriateness of PPI prescription on discharge of patients in medicine ward of a tertiary care hospital in Bangladesh.

Methods: A cross-sectional study was done for 3 months in the department of medicine in a tertiary care hospital to evaluate the indications of PPI use, appropriateness of PPI use and types of PPI prescribed. A total of 107 patients who were prescribed PPI on discharge were enrolled after written informed consent and data were collected in a structured questionnaire.

Results: Among the 107 patients discharged, 64 were males and 43 were females. The mean age was 51.3 ±17.6(SD) years.Among the study population, 49 were appropriately prescribed PPI and 58 were inappropriately prescribed PPI. Regarding indications, 53.1% received PPI for prevention of anti-platelet induced gastric erosion and 18.9% were prescribed PPI for no apparent reason. Age (p=0.199) and gender (p=0.605) was not significantly associated with the appropriate prescription of PPI.Of the various preparations of PPI prescribed, esomeprazole was prescribed in most of the discharged patients (56%).

Conclusion: This study demonstrates the existence of an overprescription ofPPI. PPI prescription needs to be improved, thereby reducingdrug interactions, adverse effects and unnecessary economical expenses.

Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 202