GRP-075 Gastroprotection with Non-Steroidal Anti-Inflammatory Drugs at Hospital Discharge: Do We Follow Local Guidelines?. (12th March 2013) - Sotoca, J
Abstract : Background: Studies have shown overuse of proton pump inhibitors (PPIs) that does not meet accepted criteria. Purpose: The aim of this study was to determine the prevalence and appropriateness of gastroprotection with PPIs in patients who were prescribed non-steroidal anti-inflammatory drugs (NSAIDs) at tertiary level hospital discharge. Materials and Methods: Data for this retrospective study were obtained from the pharmacy claims database 1–31 January 2012. We identified patients under 65 years with a concomitant PPI and NSAID and who were not taking antiplatelet drugs, anticoagulants or steroids and revised the discharge report; we considered gastroprotection appropriate if it contained a history of ulcer disease, bleeding or gastroduodenal perforation or comorbidity or treatment indicated at the time of admission. Results: During January 2012 a total of 1776 patients were dispensed at least one prescription medicine at discharge. 388 patients were dispensed an NSAID and PPI, of whom 144 also received antiplatelet treatment, anticoagulants or steroids and for whom therefore gastroprotection was recommended. We analysed the age of the 244 remaining patients. 76 of them were ≥65 years and then we also considered PPI gastroprotection appropriate. We reviewed the discharge report of the remaining 168 patients who were under 65. The result of this analysis showed that 133 patients did not fit criteria for PPI use (34.3% of patients receiving NSAIDs and PPIs); gastroprotection was correct in 27 patients and the discharge report was not recovered in 8 patients (2.1%). Conclusions: In this retrospective study, 63.6% of patients who were dispensed NSAIDs at discharge received appropriate PPI gastroprotection and 34.3% of patients received an unnecessary PPI prescription (79.2% of patients under 65). Patient prescription at hospital discharge should be reviewed to prevent overuse of proton pump inhibitors, especially in patients under 65 years of age. No conflict of interest.