PMID- 20211846
OWN - NLM
STAT- MEDLINE
DCOM- 20100812
LR  - 20181201
IS  - 1460-2393 (Electronic)
IS  - 1460-2393 (Linking)
VI  - 103
IP  - 5
DP  - 2010 May
TI  - Inappropriate utilization of intravenous proton pump inhibitors in hospital 
      practice--a prospective study of the extent of the problem and predictive 
      factors.
PG  - 327-35
LID - 10.1093/qjmed/hcq019 [doi]
AB  - BACKGROUND: Intravenous (IV) proton pump inhibitors (PPI) reduce rebleeding from 
      high-risk peptic ulcers following endoscopic therapy. The majority of IV PPI 
      prescriptions in US hospital practice are inappropriate, leading to unnecessary 
      drug costs, drug shortages and potential adverse events. To date, little is known 
      about UK hospital IV PPI prescribing practice. AIMS: To examine IV PPI use in a 
      large university teaching hospital to determine factors predicting inappropriate 
      prescribing practices. METHODS: Prospective study of 276 recently hospitalized 
      patients initiated on IV PPI over a 6-month period. IV PPI use was deemed 
      appropriate for the following indications: endoscopic evidence of recent upper 
      gastrointestinal (UGI) haemorrhage, patient nil by mouth with a valid indication 
      for oral PPI therapy and stress ulcer prophylaxis in a critical care setting. 
      RESULTS: The majority (208/276, 75.4%) of IV PPI prescriptions were deemed 
      inappropriate in terms of either indication for use, dose or duration of therapy. 
      The majority (168/276, 60.9%) of prescriptions were initiated on non-medical 
      wards. Inappropriate prescribing was more common amongst female patients, 
      surgical admissions, non-UGI haemorrhage cases and when initiated by junior 
      hospital doctors. Surgical admission [odds ratio (OR) 2.88, 95% confidence 
      interval (CI) 1.12-7.42] and female gender [OR 3.92 (95% CI 1.84-8.34)] were 
      independently predictive of inappropriate use. CONCLUSION: This study suggests 
      that the majority of IV PPI prescriptions in hospital are inappropriate, 
      particularly when initiated for non-UGI bleeding indications. Improving 
      prescribing awareness through education of junior medical staff on non-medical 
      wards could reduce inappropriate IV PPI use.
FAU - Craig, D G N
AU  - Craig DG
AD  - Department of Gastroenterology, Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ, 
      UK. darrencraig@doctors.org.uk
FAU - Thimappa, R
AU  - Thimappa R
FAU - Anand, V
AU  - Anand V
FAU - Sebastian, S
AU  - Sebastian S
LA  - eng
PT  - Journal Article
DEP - 20100307
PL  - England
TA  - QJM
JT  - QJM : monthly journal of the Association of Physicians
JID - 9438285
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Proton Pump Inhibitors)
RN  - D8TST4O562 (Pantoprazole)
SB  - IM
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles/administration & dosage/*therapeutic use
MH  - Aged
MH  - Female
MH  - Gastrointestinal Hemorrhage/*drug therapy
MH  - Hospitals, Teaching/standards/statistics & numerical data
MH  - Humans
MH  - Injections, Intravenous
MH  - Male
MH  - Medication Errors/*statistics & numerical data
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Pantoprazole
MH  - Peptic Ulcer/*complications
MH  - Practice Patterns, Physicians'
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - United Kingdom
EDAT- 2010/03/10 06:00
MHDA- 2010/08/13 06:00
CRDT- 2010/03/10 06:00
PHST- 2010/03/10 06:00 [entrez]
PHST- 2010/03/10 06:00 [pubmed]
PHST- 2010/08/13 06:00 [medline]
AID - hcq019 [pii]
AID - 10.1093/qjmed/hcq019 [doi]
PST - ppublish
SO  - QJM. 2010 May;103(5):327-35. doi: 10.1093/qjmed/hcq019. Epub 2010 Mar 7.