Evaluation of Prescribing Proton Pump Inhibitors among Hospital Inpatients in a Teaching Hospital: Report from Northwest of Iran

Abstract

Background:

Proton pump inhibitors (PPIs) are extensively used for managing gastrointestinal (GI) related disorders, but their inappropriate prescription remains a concern, leading to potential complications and increased healthcare costs. The current study was designed to evaluate the prescribing patterns of PPIs in hospital inpatients at Imam Khomeini Hospital.

Materials and Methods:

We conducted a cross-sectional study from May 2023 to July 2023 in a tertiary referral teaching hospital in Urmia, Iran. A total of 283 patients receiving PPIs were enrolled and classified into therapeutic and prophylactic groups. Prescriptions were further categorized as appropriate or inappropriate based on the protocol approved by the hospital's Rational Prescribing Committee. Demographic information, clinical outcomes, PPI indications, dosage, and administration route were collected.

Results:

80 out of 283 patients were assigned to the therapeutic group, in which 82.5% of prescriptions were compatible with the approved protocol, and the prophylactic group with 203 patients had 42.36% rational PPI administration. Oral form of PPIs was more commonly used (therapeutic: 55%, prophylactic: 87.7%). The following factors were found to be associated with appropriate prescriptions: a history of GI disorders (in the therapeutic group), pulmonary and rheumatological disorders, and the use of anticoagulants (in the prophylactic group). Inappropriate prescriptions were associated with neurological disorders (in the prophylactic group) and specific comorbidities such as hypertension and chronic obstructive pulmonary disease (in the therapeutic group).

Conclusion:

Our study revealed that inappropriate PPI prescriptions were common in this medical center. Despite having a protocol in place, continuous training for prescribers is essential. The persistence of this condition places a financial burden on healthcare systems and puts patients at risk of unintended drug-related complications.