Proton pump inhibitors - over-prescribed in a rural community?

There are specific licensed indications for the use of Proton Pump Inhibitors [PPIs]. However it is over-prescribed globally. We performed a study to find out the uses and misuses of this expensive drug in our rural and financially poor population. Prospective survey of patients successively admitted in medical and surgical wards of a teaching hospital in rural setting. Two hundred fifty successively admitted patients over a month were interviewed. Of them 144 [58%] were females. Mean age was 42 years [range = 10-100 years]. Ninety [36%] were using PPIs for which there was a licensed clinical indication in 44 [49%], whereas 46 [51%] had no definite indications. Fifty three patients [59%] who were taking PPIs were either self prescribing or were prescribed by an unqualified medical practitioner. Of these, 34 [64%] did not appear to have a valid indication. Of the remaining, 15 patients were prescribed PPI by a specialist, and 22 by a qualified general practitioner. Over half of patients [51%] in our setting are using PPIs with no definite indication. Over 2/3 [64%] of those were prescribed either by unqualified practitioner or bought over-the-counter, had no licensed indication