Inappropriate proton pump inhibitor lansoprazole prescription in older adults hospitalized in long-term care unit

Abstract

Purpose We evaluated the use of the PPI treatment by physicians in older adults hospitalized in a long-term care unit. Methods We included 40 patients aged 65 years or older with a lansoprazole prescription hospitalized in long-term care unit from January 2018 to January 2022. Patient characteristics, gastroduodenal history, dose of lansoprazole, indication, days of prescription, and number of medications were collected from electronic patient records. Results The mean age of patients was 84.2 ± 9.3. Patients were taking between 5 and 24 (mean = 12.7, SD = 4.4) medications overall with 15 patients taking low dose of aspirin (75 mg daily) and 8 patients taking an antiplatelet. Most patients (82.5%) received once-daily lansoprazole treatment, 55% of whom took a dose of 15 mg. Five patients were treated with the maximum dose of lansoprazole 30 mg twice daily. Only seven patients had an appropriate indication. The minimum of treatment time was 3 days and the maximum was 1198 days; moreover, 24 patients (60%) were still in treatment. Conclusion Few PPI prescriptions had an indication in the patient’s electronic record. Prescriptions were ongoing with no date of discontinuation or re-evaluation.

Trends in use of proton pump inhibitors among adults in the United States from 1999 to 2018

“…A 2008 study based at an outpatient geriatric practice found that 28% of those aged 65 and older had a current prescription for a PPI 10 . Another study performed in 2022 of older adults hospitalized in a long‐term care unit found that >50% of them were currently receiving a daily PPI 11 …”