Drug Utilization Pattern of Proton Pump Inhibitors in the Department of General Medicine

Abstract

Objectives: In current clinical practice, utilization of Proton Pump Inhibitors (PPIs) has increased enormously as OTC drug as well as the commonly prescribed drug in majority of the prescriptions. PPIs are predominantly indicated in prescriptions for the purpose of prophylaxis of antibiotics and analgesics. The study aimed to assess the prescribing pattern of PPIs in the Department of General Medicine of a tertiary care hospital. Methods: This is a prospective observational study conducted in the Department of General Medicine for a period of 1 year from August 2017 to July 2018 to analyse the prescribing pattern of PPIs. The medication charts of both inpatients and outpatients of General Medicine department was reviewed. Core information such as demographic characteristics, diagnosis, and current medications were recorded. The patients were regularly monitored for drug – drug interactions. Results: Of 1019 prescriptions, 908 (89%) prescriptions were found to have PPIs. Pantoprazole 749 (82.49%) was the most commonly prescribed PPI followed by esomeprazole 124 (13.66%). The indications for PPI therapy were acute gastroenteritis 103 (11.34%), ulcers 7 (0.77%), gastro esophageal reflux disease 5 (0.55%), gastrointestinal bleed 3 (0.33%), ulcerative colitis 2 (0.22%), inflammatory bowel disease 1(0.11%), esophageal and gastric injury 1(0.11%) and gastric erosion 1 (0.11%). PPIs were found to be prescribed with antibiotics 681 (75%) followed by non-steroidal anti-inflammatory drugs 179 (19.7%). Conclusions: The study showed inappropriateness in prescribing patterns of PPIs leading to increased therapeutic burden and treatment cost. This necessitates formulation of standard therapeutic guidelines for rationalizing the utilization of PPIs.

Keywords

• acute gastritis
• drug-drug interactions
• polypharmacy
• proton pump inhibitors
• pantoprazole