Potential Costs of Inappropriate Use of Proton Pump Inhibitors

Publication Date

2014

Journal Title

Am J Med Sci

Abstract

Background: Proton pump inhibitors (PPIs) are commonly overused in hospitalized patients. The objectives of this study were to determine the extent of their inappropriate initiation in patients with low risk for gastrointestinal hemorrhage, factors associated with their continuation on discharge and potential cost of this trend. Methods: Retrospective examination of patients with low risk for gastrointestinal hemorrhage admitted to a tertiary-care teaching hospital over a 3-month period who received esomeprazole. The following information was collected: age, gender, PPI status (de novo or continued) and admitting diagnoses. Additional information collected from the de novo subgroup included indication for PPI, number of days on PPI and continuation of the drug on discharge. The cost of the medication was obtained from pharmacy records. Results: Four hundred nine patients were admitted during the study period and 204 (49.9%) received PPI de novo. Among these, 155 patients (76%) had an inappropriate indication for PPI. Of these, 62 (40%) patients were continued on PPI on discharge. Older age was a significant predictor of continuation of PPI at discharge. The estimated cost of the inpatient and outpatient inappropriate use of PPI was $12,272 and $59,272, respectively. Conclusions: PPIs are overused in the majority of hospitalized patients with low risk for gastrointestinal bleeding and this practice gets perpetuated at discharge, especially in older patients. The cost of this phenomenon is alarming.

Volume Number

347

Issue Number

6

Pages

446-451

Document Type

Article

EPub Date

2013/11/26

Status

Faculty, Northwell Researcher

Facility

School of Medicine; Northwell Health

Primary Department

General Internal Medicine

PMID

24270078

DOI

10.1097/MAJ.0b013e31829f87d5

For the public and Northwell Health campuses

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