Characteristics and Patterns of Proton Pump Inhibitors Prescribing at the Primary Health Care

Abstract

Background and objectives: the aim of this study was to analyse the utilisation of proton pump inhibitors (PPIs) during a 12-year period and to show the characteristics and patterns of their prescribing. Materials and methods: firstly, in the pharmacoepidemiological analyses the ATC/DDD methodology was used to assess the utilisation of PPIs in the Republic of Srpska. The annual PPI utilisation was expressed as a number of DDD/1000 inhabitants/year. Secondly, the cross-sectional surveys were used to reveal the characteristics of PPIs prescribing and medicines use, namely the dose, duration and indication, and possible adverse reactions. For the purposes of the surveys, the adapted version of questionnaires related to physicians’ and patients’ perspectives of medicines prescribing and use were performed. Results: the utilisation of medicines for alimentary tract and metabolism (group A/ATC classification) increased by almost threefold in a 12-year period, which was consistent with the total medicine utilisation. Pantoprazole was the most prescribed medicine among the PPIs. With the exclusion of PPIs in the therapy of Helicobacter pylori eradication, more than half of family physicians prescribed PPIs with antibiotics, and only 53/239 physicians, noticed some adverse reactions of PPIs in their patients. Most of the patients knew how to use PPIs and were taking these medicines in recommended daily doses, but approximately 45% of them were using PPIs for a long period of time (>6 months). Conclusions: the overuse of PPIs is a major concern due to potential serious adverse reactions, especially in elderly patients and in a case of prolonged exposure.

Is an optimization of the use of proton pump inhibitors feasible in the real world medical practice?

“…Однако большинство пациентов остаются на длительном приеме ИПП, часто на неопределенный срок. Исследования показали: после начала приема ИПП в больнице более 50% пациентов продолжают их принимать в течение 3-6 месяцев после выписки даже в отсутствие показаний, возможно, из-за опасения, что симптомы повторятся после отмены [5]. Таким образом, использование ИПП возрастает как в стационарных условиях, так и в амбулаторном режиме.…”