Audit of PPI Prescribing Practices: A Risk to Patient Safety?
L O’Connell1, R M O’Connell1, O Ahmed1
1Department of General Surgery, Wexford General Hospital, Wexford, Ireland.
Irish Medical Journal
|June 27, 2019
Summary
Most surgical patients (70%) are inappropriately prescribed proton pump inhibitors (PPIs), despite low risk of gastrointestinal bleeding. This audit highlights the need for judicious PPI use in surgical care to reduce costs and complications.
Area of Science:
- Gastroenterology
- Pharmacology
- Surgical Care
Background:
- Proton pump inhibitors (PPIs) are commonly prescribed to surgical patients, with 50-60% receiving them.
- The primary indication for PPI use in this population is often gastrointestinal bleeding prophylaxis.
- However, a significant proportion of surgical patients are considered low risk for major bleeding events.
Purpose of the Study:
- To conduct an audit identifying inappropriate prescribing of PPIs in a cohort of surgical inpatients.
- To assess the concordance of PPI prescriptions with established clinical guidelines.
Main Methods:
- A prospective audit was conducted over a four-month period.
- Data collection involved reviewing clinical notes and drug charts of surgical inpatients.
- The Scarpignato et al. (2016) consensus guideline on PPI indications served as the audit standard.
Main Results:
- Out of 89 included patients, 73% were on PPI therapy.
- Only 30% of patients had a documented indication for PPIs that aligned with recommendations.
- A substantial majority, 70% of PPI prescriptions, were deemed inappropriate.
Conclusions:
- Proton pump inhibitors are frequently prescribed to surgical patients without appropriate clinical indications.
- The indiscriminate use of PPIs in surgical settings leads to unnecessary healthcare costs.
- Inappropriate PPI prescribing carries potential risks of adverse complications for patients.
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