Actualité

Reassessment of inappropriate prescriptions of proton pump inhibitors in elderly in-patients

  • Pharmacie,
  • Recherche,
  • Santé-Sciences-Technologie,
Date(s)

le 17 mars 2020

Published in Ann Pharm Fr

Projet de recherche collaborative dirigé par le Dr. Laura Foucault-Fruchard

Reassessment of inappropriate prescriptions of proton pump inhibitors in elderly in-patients: It's time to take action

Abstract

Objectives - To determine the impact of awareness sessions, proposed by the pharmaceutical team to the hospital physicians, on the reassessment of off-label non-hospital proton pump inhibitor prescriptions dedicated to hospitalized patients in the internal medicine department of a university hospital.

Methods - We conducted a retrospective and comparative cohort study of in-patients aged 65 years old and older with a prescription including a proton pump inhibitor. Patients who were admitted before the implementation of the awareness sessions were enrolled in the control group; others were enrolled in the awareness experimental group. The awareness sessions relating to the appropriate use of proton pump inhibitors involved a presentation about the national consensus guidelines, their side effects, the possible drug interactions with this therapeutic class, and recommendations about proton pump inhibitor discontinuation. Discussions took place around clinical cases during this multidisciplinary meeting.

Results - In total, 105 patients were included in the control group, and 52 in the awareness experimental group. In total, 10.8% of the non-hospital prescriptions were in accordance with the guidelines. The spontaneous reassessment of non-hospital proton pump inhibitors prescriptions was significantly higher in the experimental group (55.6%) compared to the control group (35.8%) (P=0.02). At discharge, 66.7% of the off-label non-hospital proton pump inhibitor prescriptions were reassessed in the experimental group versus 28.4% in the control group P<0.01).

Conclusions -  This multidisciplinary team meetings on the appropriate use of proton pump inhibitors were proved effective to improve prescription conformity to guidelines in older patients.

Copyright © 2020 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Keywords

Inappropriate medications; Inhibiteurs de la pompe à protons; Interventions pharmaceutiques; Pharmaceutical interventions; Polypharmacie; Polypharmacy; Prescription reassessment; Proton pump inhibitors; Réévaluation des prescriptions; Traitements médicamenteux inappropriés

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