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• W2914958082 abstract "Introduction: Over the past several years, concerns have been raised about excessive use of proton pump inhibitors (PPIs). In 2009, a study done at our teaching institution revealed that PPIs were prescribed in about a third of patients, often without clear indication. An effort was then established to decrease overprescribing of PPIs by creating an awareness among internal medicine residents through educational lectures, email reminders and posting flyers in different clinic areas. Purpose of our current study was to assess recent PPI use in comparison to 2009, and to determine the success of these efforts alone in establishing PPI stewardship among residents. Methods: We randomly selected 254 outpatient medical records from January 2015-December 2015 to review. The percentage of patients receiving PPIs and mean daily milligram dose were determined. Indications for PPI use were evaluated based on history and/or findings on upper endoscopy. Key findings of this study were compared to the 2009 results.Table: Table. Upper Gastrointestinal DisordersTable: Table. Comparison of PPI prescribingResults: Two hundred fifty-four records were reviewed, mean age 55.9 years (± 13.2), 51.0% male, 85.3% Caucasian. During 2015, 93 (36.6%) were taking PPIs, compared to 83/259 (32.0%) in 2009 (P = 0.28). The most commonly prescribed PPIs were esomeprazole (61.2%), pantoprazole (46.2%), and omeprazole (33.3%). Mean daily dose (MDD) of esomeprazole was 36.1 (± 12.8) mg in 2015 vs 39.0 (± 6.3) mg in 2009 (P = 0.19). MDD of pantoprazole was 36.3 (± 11.8) mg vs 40.0 (± 0.0) mg in 2009 (P = 0.38). MDD of omeprazole was 29.5 (± 15.3) mg vs 22.0 (± 4.2) mg in 2009 (P = 0.14). GERD was listed as the primary diagnosis in 51 (54.8 %) of PPI patients, but unconfirmed in 26 (51%) vs 46% in 2009 (P = 0. 77). Use of PPIs forgastroprotection was documented in four (4.3%). Conclusion: Despite of our efforts to educate residents regarding PPI stewardship, the level of PPI prescribing and dosing has not decreased over the past several years. These findings seem to reflect current unimpressive national PPI prescribing trends. It is concluded that a more aggressive approach involving multidisciplinary teams at the institutional level is vital in establishing PPI stewardship to minimize adverse effects and costs." @default.
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• W2914958082 date "2017-10-01" @default.
• W2914958082 modified "2023-10-16" @default.
• W2914958082 title "Establishing PPI Stewardship Among Internal Medicine Residents in a Large Outpatient Clinic: A Follow-up Study" @default.
• W2914958082 doi "https://doi.org/10.14309/00000434-201710001-02784" @default.
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