Abstract
Background
There is an increasing interest in inappropriate proton pump inhibitors prescription
(InPPIp), as defined by the National Institute for Clinical Excellence (NICE) guidelines.
Aims
To evaluate the rate, trend over time and factors associated with InPPIp upon discharge
from internal medicine departments.
Methods
We evaluated patients discharged from internal medicine departments with a PPI prescription
in 2014 and 2017 at an academic referral center according to a developed algorithm.
Results
A total of 3,982 patients were included (50.8% women, 74% ≥ 65 years). The rate of
InPPIp was 44.3% (95% CI 42.8–45.9) for the entire cohort; 68.1% for subjects aged
< 65 years and 36.0% for those aged ≥ 65 years (p<0.001); 43.2% in 2014 and 45.6% in 2017 (p = 0.130). In a decision-tree analysis, after the exclusion of 448 patients with gastrointestinal
indications, 89.4% (1,580/1,766) of all InPPIp cases were of patients without dual
antiplatelet treatment (DAPT) and 8.6% (151/1,766) were of patients younger than 65
years, who were taking aspirin.
Conclusions
The rate of InPPIp is high, especially among patients not receiving DAPT and young
patients taking aspirin. Time trend analysis showed no improvement over time. Our
algorithm may serve as an automated quality measuring tool to reduce InPPIp.
Keywords
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Article info
Publication history
Published online: November 15, 2022
Accepted:
October 19,
2022
Received:
August 7,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
