Prescribing pattern of oral proton pump inhibitors in Sibu region, a multicentre study

Abstract

Introduction:

Strong evidences supporting the proton pump inhibitors (PPIs) efficacy has led to an overprescribing of PPIs globally. Recently, the reported adverse events of PPIs had arrested safety issues. This study carried out to determine the prescribing pattern of oral PPIs in Sibu government primary care settings.

Methods:

In this cross-sectional study, all PPIs prescriptions received at outpatient pharmacy from 1st October to 31st October 2017 and fulfilled the inclusion criteria reviewed with patient’s clinic card to determine the appropriateness of PPIs prescribing. Patients’ demographics, type of PPIs, indication, dosage, duration, prescribing discipline, concurrent medications and cost recorded.

Results:

According to our study, we found that 52.96% of the oral PPIs inappropriately prescribed for its indication. In our setting, PPIs mostly prescribed as gastrointestinal prophylaxis in patients on NSAIDs, including low dose aspirin (47,17%). Therefore, we assumed that patients receiving low-dose aspirin and NSAIDs may be a trigger for inappropriate PPI prescriptions in our setting. Our study also showed that 62.34% of the PPIs were prescribed for >52 weeks. It arrested our attention that benefits over the risks of long-term PPI use should be assessed. We found that PPIs mostly prescribed inappropriately in patients <65 years old and those on ≥5 concurrent oral medications (p<0.001). Besides, orthopaedic department contributed the most inappropriate prescription of oral PPIs (p<0.001). From our study, we estimated that inappropriate prescribing of oral PPIs has led to expenditure of RM 24,864.83 per year.

Conclusion:

Remedial actions such as assessing the indication to initiate oral PPIs and the need for ongoing PPIs use could be implemented to curb the inappropriate PPIs use.