Abstract
Objectives
To evaluate the appropriateness of initiation of proton pump inhibitor (PPI) treatment in hospital, the quality of discharge information, and any association with continued treatment in the community.
Method
Survey of all inpatients newly initiated on a PPI in June–August 2003. Assessment of appropriateness of therapy and completeness of discharge information; assessment of continuation of PPI therapy in the community after 6 months.
Results
Thirty-five of 58 patients (60%) were considered appropriately commenced on PPI treatment. Less than 25% of patients discharged on a PPI had discharge information recommending duration of treatment or review. In the “appropriate” group 30 patients (86%) were discharged on omeprazole, and 13/21 (62%) evaluable patients remained on this at 6 months. In the “inappropriate” group 15 (65%) were discharged on omeprazole, and 10/14 (71%) evaluable patients remained on this at 6 months. Older patients remained on omeprazole for a longer duration but appropriateness of commencement did not influence the duration of treatment. Dose titration was attempted for 10 (29%) patients including three from the “inappropriate” group.
Conclusion
Care should be taken to commence PPIs only when clinically indicated. Discharge information to GPs, especially recommendations for duration of treatment and/or dose titration, requires improvement.
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References
Robinson M. Proton pump inhibitors: update on their role in acid-related gastrointestinal diseases. Int J Clin Pract 2005;59(6):709–15.
Church N, Palmer K. Acute non-variceal gastrointestinal haemorrhage treatment. In: Mc Donald J, Burroughs A, Feagan B, editors, Evidence based gastroenterology and hepatology. BMJ Books: London, 2002. p. 118–39. ISBN 072791751X.
Dent J, Brun J, Fendrick AM, et al. An evidence-based appraisal of reflux disease management—the Genval Workshop Report. Gut 1999;44(Suppl. 2):S1–S16.
Pharmaceutical Management Agency, Annual Review 2004, Wellington, New Zealand: Pharmaceutical Management Agency, 2004.
Australian Department of Health and Aging, Expenditure and prescriptions twelve months to 31 March 2004. In: Pharmaceutical benefits scheme. 2 September 2004. http://www.health.gov.au/pbs/general/pubs/pbbexp/pbmar04/index. htm (3 Aug 2005).
Department of Health, Prescription Cost Analysis: England 2004. London: Department of Health, 2005.
Stowasser DA, McGuire TM, Petrie GM, et al. Information quality: a major consideration in the development of medication liaison services. Aust J Hosp Pharm 1997;27:362–6.
van Walraven C, Weinberg AL. Quality assessment of a discharge summary system. CMAJ 1995;152(9):1437–42.
Pillans PI, Kubler PA, Radford, JM, et al. Concordance between proton pump inhibitors and prescribing guidelines. Med J Aust 2000;172(1):16–8.
New Zealand Guidelines Group, Management of dyspepsia and heartburn, Wellington, New Zealand: New Zealand Guidelines Group, 2004. p. 1–118.
Acknowledgements
The authors would like to thank the hospital pharmacists who assisted with this project and The New Zealand Pharmacy Education and Research Foundation who supported the project by providing a summer studentship grant.
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Grant, K., Al-Adhami, N., Tordoff, J. et al. Continuation of Proton Pump Inhibitors from Hospital to Community. Pharm World Sci 28, 189–193 (2006). https://doi.org/10.1007/s11096-006-9028-4
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DOI: https://doi.org/10.1007/s11096-006-9028-4