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• W2912804850 abstract "Introduction: Concern about the overuse of proton pump inhibitors has been rising as data accumulate regarding potential adverse effects, including increased risk for kidney disease, Clostridium difficile infection, and hip fractures.Chronic PPI use with lack of ongoing indication is reported in as many as 40% to 65% of hospitalized patients namely after discharge.Our study aims at exploring the prevalence of inappropriate PPI use among hospitalized patients at Staten Island University Hospital, as well as upon their discharge, with a desirable goal to encourage deprescribing PPI when they are unindicated. Methods: A retrospective chart review of 266 patients admitted to SIUH from November to December 2016 was conducted. Patients older than 18 years who received PPI were included. Data were collected for diagnoses on admission and discharge, medical and surgical histories, drug history (home and discharge medications), admission labs, patients location (unit vs floor) and service (surgery vs medicine). To determine if PPI use was appropriate, we followed the 2006 American Society of Health-System Pharmacists guidelines for stress ulcer prophylaxis and therapeutic use of PPI (Fig 1). For statistical analysis, we used Chi square and student t-tests for categorical and continuous variables respectively.Figure: Indications of PPI use.Results: A total of 266 patients were prescribed PPI during hospitalization, 49.6% (122/266) were not indicated. 156 patients were discharged on PPI, 42/156 (27%) had no clear indication (Fig 2). A higher prevalence of inappropriate PPI use was observed among surgical admissions compared to medical services (67% vs 23.6%; p=0.568) (Fig 3). As for the route of administration, 42 patients received PPI intravenously, 6/42 (14%) were not indicated.Figure: Proportion of PPI prescribed on admission and discharge.Figure: Proportion of PPI prescribed by department and location.Conclusion: This study highlights the excessive inappropriate use of PPI that affects approximately half of the patients admitted across the hospital wards. A higher rate of non compliance with national guidelines for PPI use was observed among surgical admissions. A striking observation is the significant number of patients inappropriately discharged on PPI, which theoretically carries a negative impact on cost and side effects, as most of these patients tend to be kept erroneously on long term PPI. Heightened awareness for appropriate PPI use among admitting residents and attending physicians especially in surgical units, practice of routine education during rounds, as well as re-evaluation of PPI need on discharge is highly warranted to remedy this problem." @default.
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• W2912804850 date "2017-10-01" @default.
• W2912804850 modified "2023-09-26" @default.
• W2912804850 title "Trends of Proton Pump Inhibitor Use in a Tertiary Care Center: Is it Prime Time for PPI Deprescribing Guidelines?" @default.
• W2912804850 doi "https://doi.org/10.14309/00000434-201710001-01124" @default.
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