Les inhibiteurs de la pompe à protons à l’hôpital : prescription pertinente ou encore banalisée ?

Abstract

Introduction: The increasing use of Proton Pump Inhibitors (PPIs) is associated with inappropriate indication and unjustified prolonged treatment. Yet, PPIs have side effects associated with long-term use and drug interactions. The aim of this study is to assess the relevance of hospital PPI prescriptionsMaterial and method: A clinical audit was performed on the PPI prescriptions of a university hospital over one month (October 2022). The main criteria assessed were indication, dosage, and duration of treatment, against the latest guidelines of the French Higher Health Authority (HAS), and the re-evaluation of PPI prescriptions at discharge.Results: One hundred PPIs prescriptions from various medical departments were analyzed. The average age of patients included was 68 years. The most common indication for PPI prescription was the concomitant use of antithrombotics in mono or dual therapy (n=68). Overall, only 11% of prescriptions are in accordance with the recommendations. Justification for the change was documented in the patients’ charts in only 24 % of cases. No discontinuation of PPI treatment was carried out during or after hospitalization whereas it would have been justified in 49% of patient.Discussion/Conclusion: Our study confirms the low relevance rate of PPIs prescriptions in hospital but also at discharge, highlighting the need to increase awareness about it among physicians and patients. Adaptation of PPIs prescriptions can be a way for pharmacist to limit misuse.