Proton Pump Inhibitor Use and Adverse Effects in South Atlantic Hospitals

Area of Science:

• Gastroenterology
• Pharmacology
• Hospital Medicine

Background:

• Proton pump inhibitors (PPIs) are widely used for acid-related gastrointestinal disorders.
• Despite therapeutic benefits, concerns exist regarding PPI overprescription and potential adverse effects.
• The significance and impact of PPI-associated adverse events are under ongoing investigation.

Purpose of the Study:

• To assess the rate of PPI overprescription in hospitalized patients.
• To evaluate the appropriateness of PPI use based on established guidelines.
• To identify potential adverse effects associated with PPI administration in a hospital setting.

Main Methods:

• A retrospective study was conducted in 9 HCA hospitals.
• Data from 52,712 patients admitted between July 2017 and July 2019 were analyzed.
• PPI use was evaluated against National Institute for Health and Clinical Excellence (NICE) guidelines using ICD-10 codes, and adverse events like hypomagnesemia, pneumonia, and C. difficile infection were assessed.

Main Results:

• Over half (53.1%) of the patients received PPIs without an appropriate diagnosis based on ICD-10 codes.
• Appropriate PPI use varied significantly across hospitals, ranging from 36.1% to 62.8%.
• Patients on PPIs exhibited increased rates of pneumonia and hypomagnesemia compared to age-matched populations.

Conclusions:

• PPIs are overprescribed in the studied hospitals, deviating from NICE guidelines.
• Non-indicated PPI administration is associated with increased incidence of adverse effects, including pneumonia and hypomagnesemia.
• Improved hospital prescribing practices are necessary to reduce PPI overprescription and mitigate associated risks.