Hebbar, R.; Ahmed, Z.; Zulfiker, M.S.; Scott-Thomas, S.; Hawkes, N.D.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA83
Academic Journal
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.


Related Articles

  • Functional dyspepsia: bye-bye to PPIs. Nyren, O. // Gut;Oct2002, Vol. 51 Issue 4, p464 

    Investigates the absence of therapeutic benefit of proton pump inhibitor therapy among Chinese patients with functional dyspepsia. Prevalence of dyspepsia; Production of symptoms in functional dyspepsia; Clinical manifestations; Implications for therapy.

  • PPI can help mask tumours in dyspepsia.  // Pulse;10/19/2011, Vol. 71 Issue 34, p14 

    The article offers tips on the use of proton pump inhibitor (PPI) in patient with dyspepsia.

  • CONFERENCE ROUND-UP.  // Pulse;10/28/2009, Vol. 69 Issue 34, p14 

    The article offers news briefs related to medical care in Great Britain. More patients with Crohn's disease were admitted to hospital because of flare-ups than in most other European countries. According to Scottish researchers, Framingham massively over-estimates the risk of cardiovascular...

  • Lansoprazole ineffective for functional dyspepsia. Mounsey, Anne L. // Journal of Family Practice;Dec2002, Vol. 51 Issue 12, p1015 

    The article discusses research being done on the efficacy of different doses of lansoprazole, a proton pump inhibitor, on the treatment of functional dyspepsia. It references a study by W. M. Wong, B. C. Wong, W. K. Hung et al published in the 2002 issue of "Gut." The study found that...

  • Blanket H pylori testing questioned. Polak, Monika // GP: General Practitioner;3/1/2004, p27 

    Patients with uncomplicated dyspepsia should either receive a proton pump inhibitor as first-line therapy or undergo testing and treatment for Helicobacter pylori, according to draft guidance from National Institute for Clinical Excellence (NICE). Chairman of the Primary Care Society for...

  • Review: Proton-pump inhibitor therapy reduces symptoms in nonulcer dyspepsia better than placebo.  // ACP Journal Club;May/Jun2005, Vol. 142 Issue 3, p74 

    This article presents a study, which reports that proton-pump inhibitor (PPI) therapy reduces symptoms in nonulcer dyspepsia (NUD) better than placebo. The study method consisted of randomized controlled trials that compared PPI therapy with placebo, receptor antagonists, prokinetic therapy,...

  • NICE overlooks GORD in dyspepsia advice. Baines, Emma // GP: General Practitioner;8/30/2004, p1 

    This article informs that NICE guidance on dyspepsia has been criticized for failing to provide clear enough advice on the management of gastro-oesophageal reflux disease (GORD). The guidance, published last week, recommends that patients with dyspepsia in the absence of alarm symptoms can be...

  • Omeprazole was effective in the short term for uninvestigated dyspepsia. Rabeneck, L.; Souchek, J.; Wristers, k.; Talley, Nicholas J. // ACP Journal Club;May/Jun2003, Vol. 138 Issue 3, p70 

    Summarizes a study that determined whether a proton-pump inhibitor is effective in the treatment of patients with uninvestigated dyspepsia. Characterization of the patients; Main outcome measures; Results of the study.

  • Dyspepsia management in the millennium: to test and treat or not? Delaney, B.C. // Gut;Jan2003, Vol. 52 Issue 1, p10 

    Examines the cost effectiveness of testing and treating uninvestigated dyspepsia with endoscopy for non-responders compared with empiric proton pump inhibitor (PPI) treatment followed by endoscopy, or with strategies of test and treat followed by empiric PPI, with endoscopy reserved for...


Read the Article


Sign out of this library

Other Topics