TITLE

PREVALANCE AND APPLICABILITY OF PROTON PUMP INHIBITOR PRESCRIPTION IN SECONDARY CARE

AUTHOR(S)
Hebbar, R.; Ahmed, Z.; Zulfiker, M.S.; Scott-Thomas, S.; Hawkes, N.D.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA83
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: NICE has issued guidance on the prescription of proton pump inhibitors (PPIs), which play an important role in managing the dyspeptic patient but constitute a major expenditure for the NHS. Aims: To establish the prevalence of PPI prescription in patients admitted to medical and surgical wards, indication for PPI use, applicability of prescription, and potential cost savings. Methods: A 1 month, prospective, proforma based study. A team of pharmacists reviewed daily all patients admitted to the designated study wards and noted details of PPI prescription. A trial investigator further reviewed the indication and applicability of prescription according to agreed criteria based on NICE and BSG guidance documents. Cost estimates were based on information in the British National Formulary (No. 44). Statistical analysis was performed using SPSS version 11. Results: Of the 960 admissions, 98 (10.2 %) were taking PPi medication, 36 males, mean age 68.4 years (range 18-94). 60/98 (62%) were long term prescriptions and 42/98 (42.9%) did not follow NICE guidance. Endoscopic investigation increased the proportion of appropriate prescriptions compared with clinical based decisions (Χ = 14.5, p < 0.001). Details are shown for each indication (see table). Estimated annual savings for this cohort over a 12 month period were 13 420. Assuming constant admission and PPI prevalence rates, this represents a potential annual saving of 161 042 for the community drug budget. Conclusions: We found a prevalence of 10.2% of patients on PPI medication. NICE guidance was not followed in 43% of this inpatient cohort taking PPIs. Specialist review of inpatients can play a significant role in reducing overall cost of long term PPI therapy in the community.
ACCESSION #
9747839

 

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