Evaluation of Proton Pump Inhibitors Prescribing Among Hospitalized Patients: A Cross-Sectional Study

Abukhalil, Abdallah Damin; Ali, Ola A. Abu; Saad, Asmaa; Falana, Hiba; Al-Shami, Ni’meh; Naseef, Hani; Rabba, Abdullah

doi:10.2147/ijgm.s396202

Cited by 4 publications

(1 citation statement)

References 27 publications

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“…18 A high prevalence of prescribing PPIs among cardiovascular patients receiving antiplatelet therapy has been reported by many studies; furthermore, inappropriate prescribing of PPIs has been documented. [19][20][21][22] However, no studies have been conducted in Palestine to determine physician adherence to the FDA recommendations when prescribing PPIs and clopidogrel and the clinical interaction associated with this combination. In this study, we utilized data from the Nat Health Insurance claim processor to examine the prescriber's adherence to FDA recommendations and evaluate whether each of the four PPIs (omeprazole, esomeprazole, pantoprazole, and lansoprazole) is associated with an increased risk of cardiovascular events when used concomitantly with clopidogrel.…”

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confidence: 99%

Prevalence and Safety of Prescribing PPIs with Clopidogrel in Palestine

Abukhalil¹,

Sheikh²,

Muallem³

et al. 2023

PPA

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Background: Proton pump inhibitors (PPIs) are commonly prescribed medications that are thought to increase the risk of cardiovascular events because they reduce the effectiveness of clopidogrel via shared hepatic pathways. Objective: This study examined the prevalence of concomitant prescribing of clopidogrel/PPI among patients diagnosed with acute coronary syndrome and the adverse cardiovascular event associated with this interaction. Methods: A retrospective cohort study was conducted by retrieving patient data from the Nat Health Insurance claims processor database in Palestine. Adults diagnosed with Acute Coronary Syndrome (ACS) from 2019 through 2021 who were prescribed clopidogrel or clopidogrel in combination with a PPI were included in the study. Endpoints were adverse cardiac events, including readmission for revascularization during the first year of treatment. Results:The study included 443 patients; the prevalence of prescribing concomitant clopidogrel with a PPI was 74.7%, whereas 49.2% were prescribed interacting PPI (omeprazole, esomeprazole, and lansoprazole). 59 (13.3%) of participants experienced a cardiovascular event within 1 year of starting therapy, including 27 (12.4%) patients who had a cardiovascular event while taking an interacting PPI. No significant association was found between PPI administration and increased CV event risk in patients receiving concomitant clopidogrel and PPIs therapy (p = 0.579). Conclusion:In this study, we observed a high prevalence of prescribing a PPI in combination with clopidogrel, regardless of the FDA recommendations. No significant increase in cardiovascular events was observed in patients receiving concomitant clopidogrel and PPI therapy.

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Section: Introductionmentioning

confidence: 99%

Prevalence and Safety of Prescribing PPIs with Clopidogrel in Palestine

Abukhalil¹,

Sheikh²,

Muallem³

et al. 2023

PPA

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Current status of proton pump inhibitor usage in patients with acute coronary syndrome and nonvalvular atrial fibrillation: A cross-sectional study

Bai,

Wang,

et al. 2024

Preprint

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Objective The real-world status of proton pump inhibitor (PPI) administration in patients with acute coronary syndrome (ACS) and atrial fibrillation (AF) is largely unknown. This study aimed to analyze the prescription patterns of PPI in Chinese patients with ACS and nonvalvular AF. Methods This single-center, retrospective, cross-sectional study included patients with ACS and AF who were hospitalized in the Department of Cardiovascular Center at Beijing Tongren Hospital from January 2010 to December 2018. All patients were categorized into two groups (PPI and non-PPI groups) based on PPI usage, and factors influencing PPI use were analyzed. The appropriateness of PPIs prescriptions was evaluated according to clinical guidelines. Results This study included 531 patients with ACS and AF. Patients receiving PPIs were more likely to have non-ST-segment elevation myocardial infarction (NSTEMI) (27.6% vs. 19.5%, p = 0.028), STEMI (33.9% vs. 16.2%, p < 0.001), paroxysmal AF (65.0% vs. 50.5%, p < 0.001), gastrointestinal disorders (59.4% vs. 7.9%, p < 0.001), and lower systolic blood pressure (125mmHg vs. 130mmHg, p = 0.008) as well as underwent percutaneous coronary intervention or coronary artery bypass graft or fibrinolytic (44.1% vs. 35.4%, p = 0.040) and catheter ablation (9.1% vs. 1.4%, p < 0.001), they were frequently treated with oral anticoagulants (30.7% vs. 19.9%, p = 0.003). 249 (46.9%) patients did not adhere to guideline recommendations at discharge. Conclusions The study revealed that 47.8% of patients with AF and ACS were prescribed PPI, while 46.9% of patients did not adhere to guideline. It is likely that interventions will be necessary to enhance adherence to guidelines to reduce the risk of GIB.

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Appropriateness and Cost of Prophylaxis Stress Ulcer for Inpatient in the Internal Medicine Department in a Government Hospital: A Cross-Sectional Study

Octavia,

Maziyyah,

Fauziyah

2024

Borneo J Pharm

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Guidelines from the American Society of Health-System Pharmacists (ASHP) 1999 prohibit acid-suppressing therapy for stress ulcer prophylaxis (SUP) in patients who are not critically ill. Stress ulcer prophylaxis is not recommended in non-ICU patients with <2 risk factors. Inappropriate use of SUP can increase costs for patients. This study aims to evaluate the use and the cost of SUP. This research was a non-experimental observational study with a cross-sectional approach. Data was collected retrospectively using the consecutive sampling method with a random sampling technique on the medical records of inpatients in the internal medicine ward of Sleman Regional Public Hospital from January to December 2020, totaling 340 samples. The results showed that proton pump inhibitors were the most widely used acid-suppressing drugs, with 45.8%. Furthermore, the histamine-2 receptor antagonist was 42.6%, the sucralfate group was 7.4%, and the antacid group was 4.2%. Of 340 patients, 57 (16.8%) were in the proper indication based on the guidelines, and 283 (83.2%) were under the wrong indication for SUP. They were using SUP with the proper indication so that the therapy could save treatment costs by Rp. 19,933,582. There was a high prevalence of inappropriate SUP prescriptions among inpatients in the internal medicine department; if these drugs were given with the appropriate indications, they could save more on the prophylaxis cost. Clinician pharmacists should develop an effective intervention strategy to reduce inappropriate SUP drugs.

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Evaluation of Proton Pump Inhibitors Prescribing Among Hospitalized Patients: A Cross-Sectional Study

Cited by 4 publications

References 27 publications

Prevalence and Safety of Prescribing PPIs with Clopidogrel in Palestine

Prevalence and Safety of Prescribing PPIs with Clopidogrel in Palestine

Current status of proton pump inhibitor usage in patients with acute coronary syndrome and nonvalvular atrial fibrillation: A cross-sectional study

Appropriateness and Cost of Prophylaxis Stress Ulcer for Inpatient in the Internal Medicine Department in a Government Hospital: A Cross-Sectional Study

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