Year 2019 / Volume 111 / Number 10
Original
The status of proton pump inhibitor use: a prescription survey of 45 hospitals in China

738-743

DOI: 10.17235/reed.2019.6155/2019

Jie Ying, Liu-Cheng Li, Cui-Yun Wu, Zhen-Wei Yu, Lian-Di Kan,

Abstract
Background: proton pump inhibitors (PPI) have been widely used in the clinic but inappropriate prescribing has also increased dramatically. Objective: to describe the prescribing patterns and assess the appropriateness of the prescribed PPI use in 45 hospitals in China. Materials and methods: PPI prescriptions for non-hospitalized patients were collected from hospitals in Beijing, Chengdu, Guangzhou and Hangzhou of China over a 40-day period in 2016. These data were analyzed using the prescription number, proportion and economic indicators (defined daily dose system [DDD], defined daily cost [DDC] and drug utilization index [DUI]). The evaluation criteria of PPI use was based on Martindale: The Complete Drug Reference, New Materia Medica and drug instructions. Results: in total, 357,687 prescriptions using oral PPI and 38,216 prescriptions using injectable PPI were assessed. The average age of PPI users was 53 years. The most commonly used oral PPI was rabeprazole, while the most common injectable PPI was pantoprazole. The DDD of oral rabeprazole and DDC of injectable rabeprazole were the highest. Meanwhile, only the DUI values of oral rabeprazole, lansoprazole and ilaprazole were less than 1.0. The clinical diagnosis of some users included well identified risky comorbidities such as kidney disease (2.9%). Furthermore, between 32.6% and 56.8% of the PPI prescriptions were used for inappropriate indications. Conclusion: this survey demonstrated that PPI use was accompanied by unapproved indications and excessive dosages. Comprehensive measures are urgently needed to improve PPI use and reduce unnecessary drug costs.
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14/10/2019 10:54:11
PPI use was accompanied by unapproved indications and excessive dosages. It has been a global issue which needs special attention. The hospitals and other related departments need to improve PPI use.


References
1.Malfertheiner P, Kandulski A, Venerito M. Proton-pump inhibitors:understanding the complications and risks. Nat Rev Gastroenterol Hepatol 2017; 14(12):697-710.
2.Joret-Descout P, Dauger S, Bellaiche M, et al. Guidelines for proton pump inhibitor prescriptions in paediatric intensive care unit. Int J Clin Pharm 2017; 39(1):181-186.
3.Yu LY, Sun LN, Zhang XH, et al. A review of the novel application and potential adverse effects of proton pump inhibitors. Adv Ther 2017; 34(5):1070-1086.
4.De Bruyne P, Ito S. Toxicity of long-term use of proton pump inhibitors in children. Arch Dis Child 2018; 103(1):78-82.
5.Shiraev TP, Bullen A. Proton pump inhibitors and cardiovascular events:A systematic review. Heart Lung Circ 2018; 27(4):443-450.
6.Klatte DCF, Gasparini A, Xu H, et al. Association between proton pump inhibitor use and risk of progression of chronic kidney disease. Gastroenterology 2017; 153(3):702-710.
7.Granero-Melcon B, Morrás I, Galán-DeJuana M, et al. Appropriateness of the use of proton pump inhibitors in the Emergency Department of a Spanish university hospital. Rev Esp Enferm Dig 2018; 110(12):755-761.
8.Xie Y, Bowe B, Li T, et al. Proton pump inhibitors and risk of incident CKD and progression to ESRD. J Am Soc Nephrol 2016; 27(10):3153-3163
9.Klepser DG, Collier DS, Cochran GL. Proton pump inhibitors and acute kidney injury:a nested case-control study. BMC Nephrol 2013; 14:150.
10.Lazarus B, Chen Y, Wilson FP, et al. Proton pump inhibitor use and the risk of chronic kidney disease. JAMA Intern Med 2016; 176(2):238-246.
11.Lambert AA, Lam JO, Paik JJ, et al. Risk of community-acquired pneumonia with outpatient proton-pump inhibitor therapy: a systematic review and meta-analysis. PloS One 2015; 10(6): e0128004.
12.Yang YX, Lewis JD, Epstein S, et al. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA 2006; 296(24):2947-2953.
13.Haenisch B, von Holt K, Wiese B, et al. Risk of dementia in elderly patients with the use of proton pump inhibitors. Eur Arch Psychiatry Clin Neurosci 2015; 265(5):419-428.
14.Gomm W, von Holt K, Thome F, et al. Association of proton pump inhibitors with risk of dementia: A pharmacoepidemiological claims data analysis. JAMA Neurol 2016; 73(4):410-416.
15.Lam JR, Schneider JL, Zhao W, et al. Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA 2013; 310(22):2435-2442.
16.Lam JR, Schneider JL, Quesenberry CP, et al. Proton pump inhibitor and histamine-2 receptor antagonist use and iron deficiency. Gastroenterology 2017; 152(4):821-829.e1.
17.Sharara AI, Chalhoub JM, Hammoud N, et al. Low prevalence of hypomagnesemia in long-term recipients of proton pump inhibitorsin a managed care cohort. Clin Gastroenterol Hepatol 2016; 14(2):317-321.
18.Teng L, Xin HW, Blix HS, et al. Review of the use of defined daily dose concept in drug utilisation research in China. Pharmacoepidemiol Drug Saf 2012; 21(10):1118-1124.
19.Han G, Yu Z, Ma K. Current status of parenteral nutrition and enteral nutrition application: an assessment of nutritional prescriptions from 59 hospitals in the People's Republic of China. Ther Clin Risk Manag 2015; 11:201-207.
20.Othman F, Card TR, Crooks CJ. Proton pump inhibitor prescribing patterns in the UK:a primary care database study. Pharmacoepidemiol Drug Saf 2016; 25(9):1079-1087.
21.Ahrens D, Chenot JF, Behrens G, et al. Appropriateness of treatment recommendations for PPI in hospital discharge letters. Eur J Clin Pharmacol 2010; 66(12):1265-1271.
22.Hu W, Tong J, Kuang X, et al. Influence of proton pump inhibitors on clinical outcomes in coronary heart disease patients receiving aspirin and clopidogrel: A meta-analysis. Medicine (Baltimore) 2018; 97(3):e9638.
23.Eusebi LH, Rabitti S, Artesiani ML, et al. Proton pump inhibitors: Risks of long-term use. J Gastroenterol Hepatol 2017; 32(7):1295-1302.
24.Katz MH. Failing the acid test: benefits of proton pump inhibitors may not justify the risks for many users. Arch Intern Med 2010; 170(9):747-748.
25.Eusebi LH, Rabitti S, Artesiani ML, et al. Proton pump inhibitors: Risks of long-term use. J Gastroenterol Hepatol 2017; 32(7):1295-1302.
26.Kamal F, Khan MA, Howden CW. Proton pump inhibitors and chronic kidney disease. Kidney Int 2017; 92(2):515.
27.Granero-Melcon B, Morrás I, Galán-DeJuana M, et al. Appropriateness of the use of proton pump inhibitors in the Emergency Department of a Spanish university hospital. Rev Esp Enferm Dig 2018; 110(12):755-761.
28.de la Coba Ortiz C, Argüelles Arias F, Martín de Argila de Prados C, et al. Proton-pump inhibitors adverse effects: a review of the evidence and position statement by the Sociedad Española de Patología Digestiva. Rev Esp Enferm Dig 2016; 108(4):207-224.
29.Poh CH, Navarro-Rodriguez T, Fass R. Review: treatment of gastroesophageal reflux disease in the elderly. Am J Med 2010; 123(6):496-501.
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Ying J, Li L, Wu C, Yu Z, Kan L. The status of proton pump inhibitor use: a prescription survey of 45 hospitals in China. 6155/2019


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Publication history

Received: 02/01/2019

Accepted: 15/04/2019

Online First: 02/08/2019

Published: 03/10/2019

Article revision time: 91 days

Article Online First time: 212 days

Article editing time: 274 days


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