Evaluation of Acid-Suppressive Medications Prescribing and Usage in Central Hospitals in Abha Region, Saudi Arabia
DOI:
https://doi.org/10.30827/ars.v60i2.8687Keywords:
Acid, suppressive, drugs, prescriptionAbstract
Objective: The aim of this study was to study and assess the indications of acid suppressive drugs and to find out percentage of irrational prescriptions with acid suppressive drugs.
Material/Methods: It is a prospective observational study conducted in the Armed Forces Hospitals Southern Region and Abha Maternity Hospital, both in Abha in Assir region (Saudi Arabia). The sample size of study was 185 patients. The case sheets of the patients’ prescription order were reviewed for acid suppressive drugs prescription and relevant data was taken. Patients’ age above 18 were identified. The duration of study was 8 weeks, between May and June 2017.
Results: Our results showed that the majority of the prescriptions of proton pump inhibitors (68.1%) were unjustifiable and that proton pump inhibitor was the most commonly prescribed acid suppressive drugs for the patients (97.8%). The frequency of prescribing for the autism spectrum disorders in our study was found to be higher in patients with an existing risk factor and was mostly recommended by physicians as concomitant medications (67.6%). The most common concomitant medications used with the proton pump inhibitors were non-steroidal anti-inflammatory drugs (29.2%) in which aspirin composed 13.5% of the non-steroidal anti-inflammatory drugs prescribed followed by antimicrobials (9.2%).
Conclusion: Acid suppressive drugs are the most commonly prescribed drugs with no proper indications hence irrational. Based on the results of this study, creating awareness about reasonable use of acid suppressive drugs is a necessity.
Downloads
References
Eriksson S, Långström G, Rikner L, Carlsson R and Naesdal J. Omeprazole and H2-receptor antagonists in the acute treatment of duodenal ulcer, gastric ulcer and reflux oesophagitis. Eur. J. Gastroenterol. Hepatol , 1995, 7 467-475.
Blume H, Donath F, Warnke A and Schug B. Pharmacokinetic drug interaction profiles of proton pump inhibitors. Drug Saf, 2006, 29(9) 769-84. Doi:10.2165/00002018-200629090-00002
Bashford JN, Norwood J and Chapman SR. Why patients are prescribed proton pump inhibitors? Retrospective analysis of link between morbidity and prescribing in the General Practice Research Database. BMJ, 1998, 15 317 (7156) 452-6
Julapalli VR and Graham DY. Appropriate use of intravenous proton pump inhibitors in the management of bleeding peptic ulcer. Dig Dis Sci, 2005, 50 1185-93. Doi: 10.1177/1756283X09352095
Katelaris PH. Proton pump inhibitors. Med. J. Aust. 1998, 169 (4) 208-11.
Reilly JP. Safety profile of the proton-pump inhibitors. Am. J. Health-Syst. Pharm., 1999, 56 (23 Suppl 4) 11-7. Doi:10.1093/ajhp/56.suppl_4.S11
Lewis SJ, Franco S, Young G, O and Keefe SJ. Altered bowel function and duodenal bacterial overgrowth in patients treated with omeprazole. Aliment Pharmcol Ther , 1996, 10 (4) 557-61.
Waldum HL, Brenna E, Kleveland PM, Sandvik AK and Syversen U. Review article: the use of gastric acid-inhibitory drugs, physiological and pathophysiological considerations. Aliment Pharmacol Ther 1993, 7 (6) 589-96.
Yang YX, Lewis JD, Epstein S and Metz DC. Long term proton pump inhibitor therapy and risk of hip fracture. JAMA, 2006, 296(24) 2947–53. Doi:10.1001/jama.296.24.2947
Eurich DT, Sadowski CA, Simpson SH, Marrie TJ and Majumdar SR. Recurrent community-acquired pneumonia in patients starting acid-suppressing drugs. Am J Med, 2010, 123 (1) 47-53. Doi:10.1016/j.amjmed.2009.05.032
Sachs G. Proton pump inhibitors and acid-related diseases. Pharmacotherapy 1997, 17 (1) 22-37.
Bashford JN, Norwood J and Chapman SR. Why patients are prescribed proton pump inhibitors? Retrospective analysis of link between morbidity and prescribing in the General Practice Research Database. BMJ, 1998, 317 (7156) 452-6.
Heidelbaugh JJ and Inadomi JM. Magnitude and economic impact of inappropriate use of stress ulcer prophylaxis in Non-ICU hospitalized patients. Am J Gastroenterol, 2006, 101:2200-5. Doi:10.1111/j.1572-0241.2006.00839.x
Sebastian SS, Kernan N, Qasim A, O’Morain CA and Buckley M. Appropriateness of gastric antisecretory therapy in hospital practice. Indian J Med Sci. 2004, 172:115-7
Ahmed Yacoob. Improper Use of Antisecretory drugs in a Tertiary Care Teaching Hospital: An Observational Study. Saudi J Gastroenterol , 2007, 13(3):124-128. Doi: 10.4103/1319-3767.33463
Brandhagen DJ, Phaley AM, Onstad GR, Freeman ML and Lurie N. Omeprazole use at an urban county teaching hospital. J. Gen Intern Med, 1995, 109:513-5.
Maclaren R, Obritsch MD, Sherman DS, Jung R and Fish DN. Assessing adherence to an intravenous pantoprazole guideline. J Pharm Technol, 2006, 22:15-21.
Nousheen, Tadvi NA and Shareef SM. Use of proton pump inhibitors in general practice: Is it rationale? IJMRHS, 2014, 3(1) 37-42
Parente F, Cucino C, Gallus S, Bargiggia S, Greco S, Pastore L and Bianchi Porro G. Hospital use of acid-suppressive medications and its fall out on prescribing in general practice: a 1-month survey. Aliment Pharmacol Ther, 2003, 17 (12) 1503-6.
Ramirez E, Lei S, Borobia A, Pinana E, Fudio S, Munoz R and et al. Overuse of PPIs in patients at admission, during treatment, and at discharge in a tertiary Spanish hospital, Curr Clin Pharmacol , 2010, 5(4):288-97.
Tasneem Sandozi. A Comparative Study of Cost Analysis of H2 Antagonists and Proton Pump Inhibitors in a Tertiary Care Hospital. RJPBCS, 2013, 4(5): 888-897
Baron TH, Ramirez B and Richter JE. Gastrointestinal motility disorders during pregnancy. Ann Intern Med, 1993, ;118(5):366-75
Hoogerwerf WA, Pasricha PJ. Pharmacotherapy of Gastric acidity, peptic ulcers, and gastroesophageal Reflux disease. In: Laurence L. Brunton, John S Lazo Keith L.Parker, eds. The Pharmacological basis of therapeutics; Goodman & Gilman, 2006, 11ed. 971-72.
Ahrens D, Chenot J-F, Behrens G, Grimmsmann T and Kochen MM. Appropriateness of treatment recommendations for PPI in hospital discharge letters. Eur J Clin Pharmacol, 2010; 66(12):1265-71. Doi:10.1007/s00228-010-0871-9
Walker NM and McDonald J. An evaluation of the use of proton pump inhibitors. Pharm World Sci, 2001; 23(3):116-7.
Eid SM, Boueiz A, Paranji S, Mativo C, Landis RBA and Abougergi MS. Patterns and Predictors of Proton Pump Inhibitor Overuse among Academic and Non-Academic Hospitalists. Intern Med, 2010; 49 (23):2561-8.
Scagliarini R, Magnani E, Praticò A, Bocchini R, Sambo P and Pazzi P. Inadequate Use of Acid-Suppressive Therapy in Hospitalized Patients and Its Implications for General Practice. Dig Dis Sci, 2005; 50(12):2307-11. Doi:10.1007/s10620-005-3052-4
Molloy D, Molloy A, O’Loughlin C, Falconer M and Hennessy M. Inappropriate use of proton pump inhibitors. Ir J Med Sci, 2010; 179(1):73-5. Doi:10.1007/s11845-009-0426-1
Mat Saad AZ, Collins N, Lobo MM, O’Connor HJ. Proton pump inhibitors: a survey of prescribing in an Irish general hospital. Int J Clin Pract. 2005;59:31-4. Doi:10.1111/j.1742-1241.2004.00298.x
Law JK, Andrews CN and Enns R. Intravenous proton pump inhibition utilization and prescribing patterns escalation: a comparison between early and current trends in use. Gastrointest Endosc, 2009 ; 69:3-9.
Batuwitage BT, Kingham JGC, Morgan NE and Bartlett RL. Inappropriate prescribing of proton pump inhibitors in primary care. Postgrad Med J 2007; 83(975):66-8. Doi:10.1136/pgmj.2006.051151
Kumar A, Dalai CK, Ghosh AK and Ray M. Drug utilization study of co-administration of nonsteroidal anti-inflammatory drugs and gastroprotective agents in an orthopaedics outpatients department of a tertiary care hospital in West Bengal. IJBCP, 2013; 2(2):199-202.
Raghavendra B, Narendranath S, Ullal SD, Kamath R, Pai MR, Kamath S and et al. Trends in prescribing gastroprotective agents with non steroidal anti-inflammatory drugs in an Orthopaedic outpatient unit of a tertiary care hospital. J Clin Diagn Res, 2009; 3(3):1553-6.
Published
How to Cite
Issue
Section
License
Copyright (c) 2019 Khaled Mohammed Alakhali, Hadeel M. Bayoumi, Elham S. Abunakhaa, Manal Ahmed, Nada S. Alqahtani, Rasha A. Jaber, Sahar S. Alasmari, Subhya A. Alshahrani, Zohoor A. Alshahrani
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The articles, which are published in this journal, are subject to the following terms in relation to the rights of patrimonial or exploitation:
- The authors will keep their copyright and guarantee to the journal the right of first publication of their work, which will be distributed with a Creative Commons BY-NC-SA 4.0 license that allows third parties to reuse the work whenever its author, quote the original source and do not make commercial use of it.
b. The authors may adopt other non-exclusive licensing agreements for the distribution of the published version of the work (e.g., deposit it in an institutional telematic file or publish it in a monographic volume) provided that the original source of its publication is indicated.
c. Authors are allowed and advised to disseminate their work through the Internet (e.g. in institutional repositories or on their website) before and during the submission process, which can produce interesting exchanges and increase citations of the published work. (See The effect of open access).
