Background: There are raised concerns regarding the rational guidelines-based prescribing of proton pump inhibitors (PPIs) therapy in the hospital setting.
Objective: To describe the current prescribing practice of PPIs among hospitalized patients and evaluate the appropriateness of the prescribed PPIs according to established clinical guidelines.
Methods: A cross-sectional study was conducted in the medical ward of a Malaysian tertiary hospital in the state of Pahang, Malaysia. A total of 153 medical records of non-critically-ill adult patients receiving PPI therapy were investigated. The assessment of PPI prescribing was performed referring to clinical guidelines and the list of PPI-approved indications.
Results: The most frequently prescribed PPI regimen was pantoprazole 40 mg OD. Approximately 34% of the prescribed regimens were considered to be appropriate as it was consistent with the clinical guidelines. However, about 31% of the PPIs prescribed did not have a clear indication. Moreover, the inappropriate use of PPI was revealed in nearly 19% of the total PPI prescribed. Finally, 16% of the prescribed PPIs were in need of dosage adjustment due to the presence of drug-drug interactions with the concurrently used medications.
Conclusion:
Inappropriately prescribed PPIs are prevalent among non-critically ill hospitalized adult patients in a Malaysian tertiary hospital. Prescribing improvement should focus on the proper documentation of PPI-proposed indications. A clear practice-based prescribing criterion for PPIs is urgently needed.
Key words: Proton pump inhibitors, Malaysia, prescribing patterns, Clinical practice guidelines
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