[Proton pump inhibitors: Real indication or trivialized prescription?]

Abstract

Purpose: Protons Pump Inhibitors (PPIs) are widely used in France. The aim of our study was to determine the rate of exposure to PPIs in old patients and to assess the appropriateness of their prescription according to French guidelines.

Methods: We performed a descriptive study from 1st June to 30th August 2016, including all patients admitted in the department of geriatric post emergency of the university hospital of Toulouse with a prescription of PPI. Data concerning age, name of PPI, dose, indication, duration of prescription and the modification of PPI prescription were collected.

Results: Among 375 patients admitted during this period, 134 (35.7) were exposed to PPIs with a mean age of 85.9±6.6years. About one third of them were exposed to PPI more than one year (N=49). Prescription was inappropriate for the criteria "dose and indication" and "duration" for respectively 59 (44.0%) and 15 (11.2%) cases. In 50 cases (37.3%), the PPI was renewed, stopped in 69 cases (51.5%) and the dose was reduced for 15 patients (11.2%).

Conclusion: According to our data, the prescription of PPI was no appropriate in about 40% of included patients. A reassessment of their prescription with awareness of patients should be necessary to improve the good utilization of these "popular" drugs and to prevent some serious adverse reactions after long exposure.

Keywords: Adverse drug reactions; Effets indésirables; Guidelines; Inappropriate prescription; Inhibiteurs de pompe à protons; Prescription inappropriée; Proton pump inhibitors; Recommandations.