Predictors of inappropriate utilization of intravenous proton pump inhibitors.
Aliment Pharmacol Ther
; 25(5): 609-15, 2007 Mar 01.
Article
en En
| MEDLINE
| ID: mdl-17305762
ABSTRACT
BACKGROUND:
Inappropriate use of intravenous proton pump inhibitors is prevalent.AIM:
To assess appropriateness of intravenous proton pump inhibitor prescribing.METHODS:
Retrospective review of in-patient prescribing of intravenous pantoprazole over a 2-month period in 2004, in an academic centre. Prescribing was deemed appropriate before and after endoscopic haemostasis, and in fasting individuals requiring a proton pump inhibitor.RESULTS:
Amongst 107 patients, 49 (46%) had upper gastrointestinal bleeding. Overall, 33 (31%, 95% CI 22-41%) received appropriate therapy (indication, dose and duration), 61 (57%, 95% CI 47-67%) had an inappropriate indication, and 13 (12%, 95% CI 7-20%) had an incorrect treatment dose or duration. Therapy was appropriate in 20 (41%, 95% CI 27-55%) with upper gastrointestinal bleeding, and 13 (22%, 95% CI 12-33%) in the non-upper gastrointestinal bleeding group. Appropriate prescribing rates decreased (from 41% to 16%, 95% on difference CI 14-38%) when considering intravenous proton pump inhibitor use while awaiting endoscopy as inappropriate. Significant predictors of inappropriate use were increasing age and decreasing mean daily dose, with a trend for prescriptions written during evening shifts.CONCLUSION:
Inappropriate intravenous proton pump inhibitor utilization was most frequent in the non-upper gastrointestinal bleeding group, mostly for unrecognized indications. Educational interventions to optimize utilization should target prescribing in older patients, those receiving lower mean daily doses, and, perhaps, prescribing outside regular hours.
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Banco de datos:
MEDLINE
Asunto principal:
Bombas de Protones
/
Utilización de Medicamentos
/
Inhibidores de la Bomba de Protones
/
Hemorragia Gastrointestinal
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Aliment Pharmacol Ther
Asunto de la revista:
FARMACOLOGIA
/
GASTROENTEROLOGIA
/
TERAPIA POR MEDICAMENTOS
Año:
2007
Tipo del documento:
Article
País de afiliación:
Canadá