PMID- 32505566
OWN - NLM
STAT- MEDLINE
DCOM- 20210714
LR  - 20210714
IS  - 1878-3562 (Electronic)
IS  - 1590-8658 (Linking)
VI  - 52
IP  - 8
DP  - 2020 Aug
TI  - Appropriateness of proton pump inhibitors treatment in clinical practice: 
      Prospective evaluation in outpatients and perspective assessment of drug 
      optimisation.
PG  - 862-868
LID - S1590-8658(20)30196-1 [pii]
LID - 10.1016/j.dld.2020.05.005 [doi]
AB  - BACKGROUND: High rates of inappropriate proton pump inhibitor (PPI) prescriptions 
      have been reported in retrospective database analyses. Assessing the 
      appropriateness of long-term PPIs in outpatients, with a proactive approach at 
      drug optimisation may enhance treatment adequacy. AIMS: To describe the 
      characteristics of outpatients who are on long-term PPIs, to assess the magnitude 
      of inappropriate PPI prescriptions, and to evaluate the rate of drug optimisation 
      following specialist recommendations. METHODS: Appropriateness of long-term 
      (>8weeks) PPI prescription was prospectively assessed in 249 consecutive patients 
      referred to a Gastroenterology outpatient clinic. We recorded reason for 
      prescription, dose, modality, duration of therapy, and attempts at PPI 
      optimisation. RESULTS: PPIs were inappropriately prescribed in 96/249 patients 
      (38.6%). Gastro-oesophageal reflux disease (50/143, 35.0%) and prophylaxis of 
      anti-platelet/non-steroidal anti-inflammatory drugs (5/49, 10.2%) were the most 
      common PPI indications and those with the lowest rate of inappropriateness, while 
      the highest rates were observed for treatment of dyspepsia (10/12, 83.3%) and 
      anti-coagulant therapy (21/21, 100%). PPI treatment was optimised in 112 patients 
      (45.0%). CONCLUSIONS: PPIs are inappropriately used in about 40% of outpatients, 
      reflecting scant attention to guidelines. A proactive approach may improve 
      therapeutic adequacy in approximately half of patients. Educational efforts to 
      guide PPI prescription should be further pursued.
CI  - Copyright (c) 2020 Editrice Gastroenterologica Italiana S.r.l. Published by 
      Elsevier Ltd. All rights reserved.
FAU - Giannini, Edoardo G
AU  - Giannini EG
AD  - Gastroenterology Unit, Department of Internal Medicine, University of Genoa, 
      IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy. 
      Electronic address: egiannini@unige.it.
FAU - Crespi, Mattia
AU  - Crespi M
AD  - Gastroenterology Unit, Department of Internal Medicine, University of Genoa, 
      IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
FAU - Djahandideh, Afscin
AU  - Djahandideh A
AD  - Gastroenterology Unit, Department of Internal Medicine, University of Genoa, 
      IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
FAU - Demarzo, Maria Giulia
AU  - Demarzo MG
AD  - Gastroenterology Unit, Department of Internal Medicine, University of Genoa, 
      IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
FAU - Moscatelli, Alessandro
AU  - Moscatelli A
AD  - Gastroenterology Unit, Department of Internal Medicine, University of Genoa, 
      IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
FAU - Bodini, Giorgia
AU  - Bodini G
AD  - Gastroenterology Unit, Department of Internal Medicine, University of Genoa, 
      IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
FAU - Furnari, Manuele
AU  - Furnari M
AD  - Gastroenterology Unit, Department of Internal Medicine, University of Genoa, 
      IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
FAU - Marabotto, Elisa
AU  - Marabotto E
AD  - Gastroenterology Unit, Department of Internal Medicine, University of Genoa, 
      IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
FAU - Plaz Torres, Maria Corina
AU  - Plaz Torres MC
AD  - Gastroenterology Unit, Department of Internal Medicine, University of Genoa, 
      IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
FAU - Zentilin, Patrizia
AU  - Zentilin P
AD  - Gastroenterology Unit, Department of Internal Medicine, University of Genoa, 
      IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
FAU - Savarino, Vincenzo
AU  - Savarino V
AD  - Gastroenterology Unit, Department of Internal Medicine, University of Genoa, 
      IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20200603
PL  - Netherlands
TA  - Dig Liver Dis
JT  - Digestive and liver disease : official journal of the Italian Society of 
      Gastroenterology and the Italian Association for the Study of the Liver
JID - 100958385
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Aged
MH  - Ambulatory Care/statistics & numerical data
MH  - Female
MH  - Gastroenterology/methods
MH  - Humans
MH  - Inappropriate Prescribing/*statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Practice Patterns, Physicians'
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/*administration & dosage/adverse effects
OTO - NOTNLM
OT  - Gastro-oesophageal reflux disease
OT  - Long-term
OT  - Outcomes
OT  - Prescription
OT  - Proton pump inhibitors
COIS- Declaration of Competing Interest The authors have no interests to declare
EDAT- 2020/06/09 06:00
MHDA- 2021/07/15 06:00
CRDT- 2020/06/08 06:00
PHST- 2020/03/27 00:00 [received]
PHST- 2020/04/16 00:00 [revised]
PHST- 2020/05/04 00:00 [accepted]
PHST- 2020/06/09 06:00 [pubmed]
PHST- 2021/07/15 06:00 [medline]
PHST- 2020/06/08 06:00 [entrez]
AID - S1590-8658(20)30196-1 [pii]
AID - 10.1016/j.dld.2020.05.005 [doi]
PST - ppublish
SO  - Dig Liver Dis. 2020 Aug;52(8):862-868. doi: 10.1016/j.dld.2020.05.005. Epub 2020 
      Jun 3.