Appropriateness of Proton Pump Inhibitor Use in Hospitalized Patients: A Cross Sectional Study in a Tertiary Care Hospital in North India

Shivani Juneja; Proteesh Rana; Sreehari V Manoj; Rohit Kalia; Ratinder Pal Singh

doi:10.18502/jpc.v11i2.13360

Shivani Juneja Department of Clinical Pharmacology, Fortis Hospital, Mohali, India.
Proteesh Rana Department of Pharmacology, University College of Medical Sciences, Delhi, India.
Sreehari V Manoj Department of Clinical Pharmacology, Fortis Hospital, Mohali, India.
Rohit Kalia Department of Clinical Pharmacology, Fortis Hospital, Mohali, India.
Ratinder Pal Singh Department of Cardiology, Healing Super-specialty Hospital, Chandigarh, India.

DOI: https://doi.org/10.18502/jpc.v11i2.13360

Keywords: Proton Pump Inhibitors; Prescribing; Rational Use; Drug Safety

Abstract

Background: Proton Pump Inhibitors (PPIs) are often prescribed inappropriately among hospitalized patients and same is often continued even after their discharge from the hospital. The inappropriate use of PPIs leads to an increased risk of adverse effects, drug interaction, and unnecessary hospital expenditure for such patients. Aim of this study was to determine the appropriateness of PPIs use among hospitalized patients.

Methods: A cross sectional observational study was conducted on hospitalized patients in a tertiary care hospital in Northern India. The clinical records of adult patients hospitalized during April- May 2022 were assessed for the prescribing pattern and appropriateness of PPI use as per the National Institute of Health and Care Excellence (NICE) guidelines.

Results: A total of 192 patient’s records were included in this study with the mean age 57 years and 61% of the study participants were males. Overall, 72% (138) of the study participants were prescribed PPIs by intravenous route and only in 28% (54) cases an oral route was preferred. Pantoprazole was the most commonly prescribed PPI in 112 (58%) patients and it was administered by intravenous route among 87 patients (78%) and by oral route in 25 (22%) patients. PPI use was appropriate in 54% of the cases and they were most commonly prescribed for ulcer prophylaxis. This study identified higher use of PPIs was seen in low risk patients for longer duration than indicated.

Conclusion: PPIs are being prescribed inappropriately among hospitalized patient unrelated to their widely accepted clinical indications and are often continued unnecessarily once patient is discharged. These results suggest the need of regular audits on use of PPIs clubbed with educational initiatives to promote rational use of PPIs among hospitalized patients.