质子泵抑制剂(PPI)不必要处方:住院患者出院实践分析

Akhlak Ahamed
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摘要

背景:据报道,质子泵抑制剂(PPI)在不适当的临床环境中使用,经常导致不良反应、药物相互作用和成本的风险增加。目的:本研究的目的是评估在孟加拉国三级医院内科病房的病人出院时PPI处方的适宜性。方法:在某三级医院内科进行为期3个月的横断面研究,评价患者使用PPI的适应证、使用的适宜性及处方类型。在书面知情同意后,共有107名出院时服用PPI的患者入组,数据收集在结构化问卷中。结果:107例出院患者中,男64例,女43例。平均年龄51.3±17.6(SD)岁。在研究人群中,49例PPI处方合适,58例PPI处方不合适。在适应证方面,53.1%的患者为预防抗血小板性胃糜烂而使用PPI, 18.9%的患者无明显原因使用PPI。年龄(p=0.199)和性别(p=0.605)与PPI处方的适宜性无显著相关。在处方的各种PPI制剂中,大多数出院患者(56%)使用了埃索美拉唑。结论:本研究表明存在ppi的过量处方。需要改进PPI处方,从而减少药物相互作用、不良反应和不必要的经济费用。孟加拉国J医学2023;第34卷,第2(1)号补编:202
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Unnecessary Prescription of Proton Pump Inhibitors (PPI): An Analysis of Inpatient Discharge Practices
Background: Proton pump inhibitors (PPI) have reportedly been used in inappropriate clinical settings, often leading to an increased risk of adverse effects, drug interactions, and costs. Aim: The aim of this study was to evaluate the appropriateness of PPI prescription on discharge of patients in medicine ward of a tertiary care hospital in Bangladesh. Methods: A cross-sectional study was done for 3 months in the department of medicine in a tertiary care hospital to evaluate the indications of PPI use, appropriateness of PPI use and types of PPI prescribed. A total of 107 patients who were prescribed PPI on discharge were enrolled after written informed consent and data were collected in a structured questionnaire. Results: Among the 107 patients discharged, 64 were males and 43 were females. The mean age was 51.3 ±17.6(SD) years.Among the study population, 49 were appropriately prescribed PPI and 58 were inappropriately prescribed PPI. Regarding indications, 53.1% received PPI for prevention of anti-platelet induced gastric erosion and 18.9% were prescribed PPI for no apparent reason. Age (p=0.199) and gender (p=0.605) was not significantly associated with the appropriate prescription of PPI.Of the various preparations of PPI prescribed, esomeprazole was prescribed in most of the discharged patients (56%). Conclusion: This study demonstrates the existence of an overprescription ofPPI. PPI prescription needs to be improved, thereby reducingdrug interactions, adverse effects and unnecessary economical expenses. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 202
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