IDDF2018-ABS-0060 A study on the status of proton pump inhibitor prescribed for hospital inpatients in japan. (June 2018)

• Record Type: Journal Article
• Authors: Sakata, Yasuhisa; Tsuruoka, Nanae; Shimoda, Ryo; Yamaguchi, Daisuke; Fujimoto, Kazuma
• Is Part Of: Gut. Volume 67(2018)Supplement 2
• Page Start: A42
• Page End: A42
• Publication Date: 2018-06
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2018-IDDFabstracts.92
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background: In Japan, the amount of usage of proton pump inhibitors (PPIs) has been increasing as the indications extended to maintenance treatment of reflux esophagitis and prevention of ulcer recurrence in patients receiving non-steroidal anti-inflammatory agents (NSAIDs) and low-dose aspirins, in addition to the treatment of peptic ulcer. This study aimed to clarify the status of use of PPIs in hospitalised patients with Diagnosis Procedure Combination (DPC) data. Methods: A retrospective observational study was carried out. We analysed the PPI prescription data for past 8 years (2009–2016) using the DPC survey data of approximately ten thousand patients a year in Saga university hospital. The primary objective is to investigate the trend of a number of hospitalised patients who were prescribed PPI for the past 8 years. The secondary objective is to investigate the changes in the characteristics of patients (age, indication, concomitant medication, and clinical department that follows a patient). Lists of proton pump inhibitors subjected to the survey are omeprazole, esomeprazole, lansoprazole, rabeprazole and vonoprazan. Results: We identified 11 009 patients using PPIs throughout the study period. Prevalence of PPI use was higher among male than female, approximately 1.3 times. The average age of PPI users was 67.8 years. The number of PPI users increased 1.5 times during the study period, from 1071 (10.5% of inpatients) in 2009 to 1581 (12.3% of inpatients) in 2016. Lansoprazole was the most commonly used agent (30.7%–50.5%) during the study period, followed by rabeprazole (29.3%–48.6%) and esomeprazole. A newer agent, vonoprazan exhibited substantial growth in prescription rates (2.4% in 2015 and 13.8% in 2016). In most of the clinical departments, especially emergency and critical care medicine, neurology, cardiovascular surgery and nephrology, the number of patients prescribed PPIs was up to 3 times higher in the second half of the period (2013–2016) than in the first half of the period (2009–2012). Patients received PPIs concomitantly with NSAIDs and antithrombotic agents has been increased. Conclusions: The use of PPIs, as well as the approved indications for PPIs, has increased substantially in hospitalised patients. The prevalence of PPI prescription by doctors other than gastroenterologists also increased.