PMID- 20694459
OWN - NLM
STAT- MEDLINE
DCOM- 20110301
LR  - 20220408
IS  - 1432-1041 (Electronic)
IS  - 0031-6970 (Print)
IS  - 0031-6970 (Linking)
VI  - 66
IP  - 12
DP  - 2010 Dec
TI  - Appropriateness of treatment recommendations for PPI in hospital discharge 
      letters.
PG  - 1265-71
LID - 10.1007/s00228-010-0871-9 [doi]
AB  - PURPOSE: The reasons for the dramatic increase in proton pump inhibitors (PPI) 
      prescriptions remain unclear and cannot be explained solely by increased 
      morbidity, new indications or a decrease in alternative medication. Inappropriate 
      use and discharge recommendations in hospitals are considered to be possible 
      explanations. As the quality of PPI recommendations in hospital discharge letters 
      in Germany has not been investigated to date, we have studied the appropriateness 
      of these referrals. METHODS: Hospital discharge letters with recommendations for 
      PPI medication from 35 primary care practices in the county of 
      Mecklenburg-Western Pomerania (MV; North-east Germany) were collected and 
      analysed, and the appropriateness of the PPI indication was rated. RESULTS: No 
      information justifying the recommendation for continuous PPI medication could be 
      identified in 54.5% of the discharge letters; in 12.7%, the indication was 
      uncertain, and in 32.7%, we found an evidence-based indication for PPI 
      medication. The most common indication for adequate PPI use was nonsteroidal 
      anti-inflammatory drug-prophylaxis in high-risk patients. CONCLUSIONS: Inadequate 
      recommendations for PPIs in discharge letters are frequent. This may lead to a 
      continuation of this therapy in primary care, thereby unnecessarily increasing 
      polypharmacy and the risk of adverse events as well as burdening the public 
      health budget. Hospitals should therefore critically review recommendations for 
      PPI medication and the dosage thereof in their discharge letters and clearly 
      document the reason for PPI use and the need for continuous prescription in 
      primary care.
FAU - Ahrens, Dirk
AU  - Ahrens D
AD  - Department of General Practice, University of Gottingen, Humboldtallee 38, 
      Gottingen, Germany.
FAU - Chenot, Jean-Francois
AU  - Chenot JF
FAU - Behrens, Gesa
AU  - Behrens G
FAU - Grimmsmann, Thomas
AU  - Grimmsmann T
FAU - Kochen, Michael M
AU  - Kochen MM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100806
PL  - Germany
TA  - Eur J Clin Pharmacol
JT  - European journal of clinical pharmacology
JID - 1256165
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Patient Discharge
MH  - *Practice Guidelines as Topic
MH  - Proton Pump Inhibitors/*therapeutic use
PMC - PMC2982961
EDAT- 2010/08/10 06:00
MHDA- 2011/03/02 06:00
PMCR- 2010/08/06
CRDT- 2010/08/10 06:00
PHST- 2010/04/15 00:00 [received]
PHST- 2010/07/10 00:00 [accepted]
PHST- 2010/08/10 06:00 [entrez]
PHST- 2010/08/10 06:00 [pubmed]
PHST- 2011/03/02 06:00 [medline]
PHST- 2010/08/06 00:00 [pmc-release]
AID - 871 [pii]
AID - 10.1007/s00228-010-0871-9 [doi]
PST - ppublish
SO  - Eur J Clin Pharmacol. 2010 Dec;66(12):1265-71. doi: 10.1007/s00228-010-0871-9. 
      Epub 2010 Aug 6.