TBA (22W109)

Prevalence of Potentially Inappropriate Prescribing of Proton Pump Inhibitors in Older Persons

Author(s)

1. C. McAuliffe 2. D. McAuliffe 3. S. Byrne

Department(s)/Institutions

1. Department of Pharmacy, Tallaght University Hospital, Dublin, Ireland 2. School of Medicine, University of Galway, Galway, Ireland 3. Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland

Introduction

Potentially Inappropriate Prescribing (PIP) has been associated with adverse health outcomes for older persons. STOPP/START is a widely used tool to help clinicians identify instances of PIP.

Aims/Background

The aim of this study was to identify the prevalence of PIP in a cohort of older inpatients. A secondary objective was to describe the incidence and nature of the most prevalent PIP identified.

Method

In this retrospective single-center cohort study, a random sample (n=150) was selected from a cohort of older (≥75 years) inpatients. Potentially Inappropriate Medications (PIMs) and Potential Prescribing Omissions (PPOs) were identified by applying STOPP/START criteria to discharge prescriptions.

Results

There were 394 incidences of PIP identified in 88% of patients. There was a high prevalence of both PIM (72%) and PPO (63.3%). The most frequently encountered PIM was the use of Proton Pump Inhibitor (PPI) at excessive dosage beyond the recommended duration. Inappropriate PPI accounted for 26% (64/244) of all PIMs. One hundred and fourteen patients were prescribed a PPI. As per NICE guideline classification, eighty six patients taking a PPI were prescribed these at “full dose” and five patients were prescribed “double dose” PPI without indication.

Conclusions

Addressing polypharmacy has been highlighted by the World Health Organisation as a key strategy to reduce severe avoidable medication-related harm. PPIs are associated with adverse effects such as B12 malabsorption, hypomagnesemia, clostridium difficile infection, fractures and pneumonia. The risk is greater in older patients. The results of this study show that PPIs are prescribed widely and without being appropriate reviewed in older patients.