An evaluation of the use of proton pump inhibitors

To review whether Proton Pump Inhibitors (PPIs) are prescribed for appropriate indications and to assess the quality of information being supplied to GPs on discharge.

Prospective study of 85 patients consecutively admitted on, or initiated on, PPIs comparing prescribing patterns with the health authority consensus statement on PPIs and reviewing the quality of information provided to GPs on discharge.

39 patients were admitted on PPIs; 30% had absolute indications for prescribing, 3% had possible indications for prescribing and 67% were for indications other than those in the consensus statement. 46 patients had PPIs initiated as inpatients; 39% had absolute indications for prescribing, 10% had possible indications for prescribing and 51% were for indications other than those in the consensus statement. 10% of patients admitted on PPIs had therapy reviewed prior to discharge, whilst 60% of patients initiated on PPIs during admission were reviewed prior to discharge. Information provided to GPs on discharge usually included dosage and frequency. 18% of discharge letters indicated the intended duration of therapy and 7% suggested a review date. For those initiated on PPIs as inpatients 51% of discharge letters gave an indication.

Frequent review of therapy and improved communications between primary and secondary care are vital to rationalise the use of PPIs and to reduce expenditure.