An outpatient department based observational study to review the pattern of utilization of proton pump inhibitors for their co-relation with the indications in a tertiary care centre
Background: Proton pump inhibitors (PPIs) are one of the commonest drugs prescribed for a variety of indications. They are considered remarkably safe and prescribed liberally. However, on long term administration, they can cause a number of adverse effects. In a tertiary care hospital, where the patient numbers are large and many attending super speciality centre, a number of patients were observed to receive PPIs for approved and unapproved indications. It was therefore considered prudent to study the prescribed PPIs for a co-relation with their indications or otherwise so as to formulate corrective interventions.Methods: The observational study was conducted in the dispensary of a tertiary care centre. The prescriptions of the patients were the study material. Prescriptions for a full week were taken in for consideration. A total of 4142 prescriptions were studied. All aspects related to PPIs were noted and analysed. Additionally, a note on prescribed calcium supplements, vitamins and antioxidants was made.Results: Of all the prescriptions studied by us, 33% had PPIs in them. Omeprazole was the commonest PPI followed by pantoprazole. Almost half the patients prescribed PPIs, the duration of administration was over 30 days. 78% patients prescribed PPIs also had some or the other non-steroidal anti-inflammatory drug (NSAID) in their prescription. Over one fourth of the total patients also received calcium supplements, vitamins or anti-oxidants.Conclusions: Proton pump inhibitors are very popular drugs and are being prescribed for approved and unapproved indications in the hope of providing relief to the patients. They are being advised quite liberally and more so if any NSAID has been co-prescribed. Even for prescriptions lasting for less than 5 days, PPIs have been included in the presumption to prevent gastritis due to NSAIDs. This practice is contrary to guidelines and also exposes the patients to avoidable adverse drug reactions
