Hospital use of acid‐suppressive medications and its fall‐out on prescribing in general practice: a 1‐month survey

Open Access
Publisher Website
Google Scholar
Abstract
Background: Acid‐suppressive medications are commonly used in hospitalized patients, but, to date, little is known about the overall use of these drugs in the hospital setting. Aim: To evaluate the appropriateness of acid‐suppressive therapy in a large teaching hospital in northern Italy, and the fall‐out of hospital prescription in general practice. Methods: The use of antisecretory agents was monitored for 1 month in adult patients consecutively admitted to L. Sacco University Hospital by reviewing their clinical charts. The appropriateness of each prescription was reviewed jointly by two consultant gastroenterologists. Results: A total of 46.8% of 799 hospitalized patients received acid‐suppressive therapy. Ranitidine was the most frequently used drug (44.4%), followed by pantoprazole (31.8%) and omeprazole (23.0%). Stress ulcer prophylaxis and the prevention of non‐steroidal anti‐inflammatory drug‐induced ulcer accounted for 60.4% of the indications for use. Overall, 68% of prescriptions were not appropriate as determined by consensus review; 56.4% of patients receiving unnecessary prophylactic treatment whilst in hospital were discharged on therapy, and 46% were still receiving the treatment 3 months later. Conclusions: Acid‐suppressive agents are over‐used in hospitalized patients. Most of the inappropriate hospital prescriptions are for ulcer prophylaxis in low‐risk patients. This unnecessary use may also induce inappropriate drug consumption in general practice.