Reasons for initiation of proton pump inhibitor therapy for hospitalised patients and its impact on outpatient prescription in primary care
Rev. esp. enferm. dig
; 107(11): 652-658, nov. 2015. tab, ilus
Artigo
em Inglês
| IBECS
| ID: ibc-145293
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
BACKGROUND:
Proton-pump-inhibitors are often prescribed unnecessarily in hospitals, which in turn induces their prescriptions after discharge.OBJECTIVE:
To evaluate patients starting treatment with proton-pump-inhibitors during hospitalisation and proportion of inappropriate prescriptions. Patient risk factors and whether initiation in hospital induced their continuation in ambulatory care were also analyzed.METHODS:
An observational, cross-sectional study in a tertiary hospital (1350 beds) was carried out on the first Tuesday in February 2015. Pharmacists screened admitted patients treated with proton-pump-inhibitors using an electronic prescription program (FarmaTools®-5.0). They also checked patients' home medications before admission by accessing a primary care program (Horus®). Authorized indications according to Spanish-Medicines-Agency and those recommended in Spanish-Clinical-Practice- Guidelines were considered appropriate. Hospital-medical-records were checked to know whether proton-pump-inhibitors were prescribed at discharge.RESULTS:
Three hundred seventy nine patients were analysed. Two hundred ninety four of them were prescribed proton-pumpinhibitors (77.6%). Treatment was initiated during admission for 143 patients (48.6%, 95% CI 42.8-54.5). Of them, 91 (63.6%, 95% CI 55.2-71.5) were inappropriate, mainly due to its inclusion unnecessarily in protocols associated with surgeries or diseases (56 cases of 91, 61.5%). Additional inappropriate indications were surgical stress ulcer prophylaxis for surgeries without bleeding risks (19.8%) and polypharmacy without drugs that increase the risk of bleeding (18.7%). Of 232 discharge reports assessed, in 153 (65.9%, 95% CI 59.5-72), proton-pump-inhibitor continuation was recommended, of them, 51 (33.3%) were initiated at admission.CONCLUSION:
In hospitalized patients there is a high prevalence of prescription of proton-pump-inhibitors unnecessarily. The superfluous use is often associated with the prescription of treatment protocols. Those treatments started in the hospital generally did not contribute to over-use existing primary care, most of them were removed at discharge
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Espanha
Contexto em Saúde:
ODS3 - Meta 3.7 Acesso universal aos serviços de saude reprodutiva
Problema de saúde:
Infecções Sexualmente Transmissíveis: Prevenção e Cuidados
Base de dados:
IBECS
Assunto principal:
Prescrições de Medicamentos
/
Omeprazol
/
Fatores de Risco
/
Inibidores da Bomba de Prótons
/
Prescrição Eletrônica
Tipo de estudo:
Estudo de etiologia
/
Estudo de avaliação
/
Guia de prática clínica
/
Estudo observacional
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Estudo de prevalência
/
Fatores de risco
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Rev. esp. enferm. dig
Ano de publicação:
2015
Tipo de documento:
Artigo
Instituição/País de afiliação:
Hospital Universitario La Paz/Spain