The appropriate use of proton pump inhibitors in outpatient department, Ramathibodi hospital
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Abstract
ABSTRACT
Background: The inappropriate use of proton pump inhibitors (PPI) has been widely reported, and leads to adverse events and unnecessary drug interactions. This study aim to describe the prevalence and associated factors of inappropriate PPI use in the Outpatient Department, Ramathibodi Hospital
Design: A retrospective cross-sectional study
Methods: The patients were recruited into this study by a simple random sampling method, as calculated sample size. The data on PPI use were collected from electronic medical records in the Outpatient Department, Ramathibodi Hospital, 2020, 1 January 2020 to 31 December, and were analyzed by the multivariable logistic regression model.
Results: Five hundred and seven patients were analyzed. The prevalence of inappropriate PPI use was 69.82%. Significant drug interactions with PPI (mostly found in clopidogrel, mycophenolate mofetil, and methotrexate) were found in 77 patients. Steroid coadministration (odd ratio (OR)=3.86, 95% confidence interval (CI)=1.34-11.13) was associated with inappropriate PPI use. However, the associated factors of appropriate PPI use, were history of esophagogastroduodenoscopy (OR=0.49, 95%CI: = 0.31-0.78), antiplatelet coadministration (OR=0.50, 95%CI:=0.31-0.83), dual antiplatelet coadministration (OR=0.35, 95%CI:=0.14-0.91), antiplatelet with steroid coadministration (OR=0.12, 95%CI:=0.02-0.58), antiplatelet with NSAIDs coadministration (OR=0.16, 95%CI:=0.03-0.82).
Conclusion: The prevalence of inappropriate PPI use in the Outpatient Department, Ramathibodi Hospital, is quite high. Moreover, unnecessary significant drug interactions were found. Steroid coadministration was significantly associated with inappropriate PPI use
Keywords: proton pump inhibitors, inappropriate, outpatient
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