Evaluation of the prescribing of proton pump inhibitors as stress ulcer prophylaxis for non-ICU patients in a Malaysian tertiary hospital

Muhammad eid Akkawi, Mohamed hassan Elnaem

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background
Proton pump inhibitors (PPIs) are widely prescribed in hospital settings. Several reports have highlighted concerns about the inappropriate use of PPIs as stress ulcer prophylaxis (SUP) in patients outside the intensive care unit (ICU) setting. Little is known about this phenomenon in Malaysian hospitals.

Aims and objectives
This study aimed to evaluate the appropriateness of PPI prescribing as SUP for patients admitted to the general medical wards of a Malaysian tertiary hospital and to determine the rate of unnecessary prescription of PPI for discharged patients.

Methods
This was a retrospective cross-sectional study conducted in a tertiary hospital in Pahang, Malaysia. We reviewed the information held on electronic databases for patients admitted to the general medical wards from January to September 2019. Appropriateness of PPI prescribing was assessed using the criteria for SUP from predefined clinical guidelines.

Results
Of 660 screened patients admitted to the general medical wards, 200 were prescribed PPIs as SUP. Oral pantoprazole was the most frequently prescribed PPI (51.5%). Only 61 (30.5%) PPIs were prescribed according to current recommendations for the use of PPI for SUP. Sex, age, number of medications, length of hospital stay, and receiving PPI at discharge were not significantly associated with appropriateness of PPI prescribing. Half of the patients continued receiving PPIs at discharge without a documented indication.

Conclusion
Our findings indicated a high prevalence of inappropriate prescribing of PPIs as SUP for non-ICU patients. Interventions to reduce the unnecessary use of PPIs in Malaysian hospital settings are desperately required. The need for national criteria that address the proper indications and dosing regimens for PPIs as SUP in ICU and non-ICU patients is high.
Original languageEnglish
Pages (from-to)529-534
Number of pages6
JournalDrugs and Therapy Perspectives
Volume36
Issue number11
Early online date31 Aug 2020
DOIs
Publication statusPublished (in print/issue) - 1 Nov 2020

Keywords

  • esomeprazole
  • omeprazole
  • pantoprazole
  • proton pump inhibitor

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