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Inadequate Use of Acid-Suppressive Therapy in Hospitalized Patients and Its Implications for General Practice

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Abstract

Acid-suppressive therapy (AST) is largely prescribed in both hospital and general practice setting but few data are available on appropriateness of AST use in hospitalized patients and its fallout on prescribing in general practice. We assessed AST in patients consecutively admitted to an internal medicine department to determine the type and timing of prescription and indication for use according to widely accepted guidelines. Prescriptions were rated as indicated, acceptable, or not indicated. Overall, 58.7% of 834 admitted patients received AST, mainly proton pump inhibitors. The prescriptions were indicated in 50.1% of patients, not indicated in 41.5%, and acceptable in 6.5%. The main reason for inappropriate use was prophylaxis in low-risk patients (64.8%). On admission, 35.7% of 112 patients already on AST were judged to receive inappropriate prescription; of 348 patients discharged on AST, overuse was identified in 38.5%. No significant difference was observed for inappropriate use at admission, during hospitalization, and at discharge. In 64 inpatients (7.7%) AST, although indicated, mainly for ulcer prophylaxis in high-risk patients, was not prescribed. In conclusion, AST is substantially overused in both hospital and general practice settings, mainly for ulcer prophylaxis in low-risk patients. On the other hand, AST is underused in a small, but not negligible proportion of high-risk patients.

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Authors and Affiliations

  1. The Department of Internal Medicine, “M. Bufalini” Hospital, Cesena, Italy

    Raffaella Scagliarini MD, Elena Magnani MD, Antonino Praticò MD, Renato Bocchini MD, Paola Sambo MD & Paolo Pazzi MD, FACG (Dr.)

  2. Department of Internal Medicine, “M. Bufalini” Hospital, Corso Ghirotti 286, 47023, Cesena, FC, Italy

    Paolo Pazzi MD, FACG (Dr.)

Authors
  1. Raffaella Scagliarini MD
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  2. Elena Magnani MD
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  3. Antonino Praticò MD
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  4. Renato Bocchini MD
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  5. Paola Sambo MD
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  6. Paolo Pazzi MD, FACG
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Correspondence to Paolo Pazzi MD, FACG.

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Scagliarini, R., Magnani, E., Praticò, A. et al. Inadequate Use of Acid-Suppressive Therapy in Hospitalized Patients and Its Implications for General Practice. Dig Dis Sci 50, 2307–2311 (2005). https://doi.org/10.1007/s10620-005-3052-4

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  • DOI: https://doi.org/10.1007/s10620-005-3052-4

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