Co-prescription of gastro-protectants in hospitalized patients: an analysis of what we do and what we think we do.

Hdl Handle:
http://hdl.handle.net/10147/127500
Title:
Co-prescription of gastro-protectants in hospitalized patients: an analysis of what we do and what we think we do.
Authors:
Doherty, Glen A; Cannon, Mary D; Lynch, Karen M; Ayoubi, Karim Z; Harewood, Gavin C; Patchett, Stephen E; Murray, Frank E
Affiliation:
Division of Gastroenterology and Hepatology, Beaumont Hospital, Royal College of Surgeons, Beaumont, Dublin, Ireland
Citation:
Co-prescription of gastro-protectants in hospitalized patients: an analysis of what we do and what we think we do. 2010, 44 (3):e51-6 J. Clin. Gastroenterol.
Journal:
Journal of clinical gastroenterology
Issue Date:
Mar-2010
URI:
http://hdl.handle.net/10147/127500
DOI:
10.1097/MCG.0b013e3181a9f43b
PubMed ID:
19609216
Abstract:
Proton pump inhibitors (PPIs) reduce the risk of upper gastrointestinal hemorrhage (UGIH) associated with the use of many medications.; To examine how clinicians perceive such risk and whether PPI co-prescribing is based on an accurate assessment.; Clinicians in a single teaching hospital were asked to estimate risk of UGIH and comment on PPI co-prescription in hypothetical patients. Records of 160 hospital in-patients (median age; 74 y) were then reviewed to examine PPI prescribing and risk factors for UGIH.; In general, clinicians estimated UGIH risk accurately and reported low thresholds for PPI co-prescription. Prescribing records showed regular PPI use increased between admission and discharge of patients from 61/160 (38%) to 93/160 (58%). Ten percent had a prior history of peptic ulcer disease. Proton pump inhibitor prescription was significantly associated with the use of aspirin and clopidogrel. Half of the patients with multiple risk factors for UGIH on admission and almost a third at discharge were not co-prescribed a PPI.; Clinicians generally estimate correctly the risk of UGIH and report a low threshold for prescribing gastro-protection. Despite this, prescribing practice does not consistently take account of relative risk of UGIH. Targeted PPI co-prescribing on the basis of risk factors would lead to more rational PPI use.
Item Type:
Article
Language:
en
MeSH:
Aged; Aged, 80 and over; Aspirin; Attitude of Health Personnel; Data Collection; Female; Gastrointestinal Hemorrhage; Hospitals, Teaching; Humans; Male; Middle Aged; Peptic Ulcer; Physician's Practice Patterns; Platelet Aggregation Inhibitors; Proton Pump Inhibitors; Risk Factors; Ticlopidine
ISSN:
1539-2031

Full metadata record

DC FieldValue Language
dc.contributor.authorDoherty, Glen Aen
dc.contributor.authorCannon, Mary Den
dc.contributor.authorLynch, Karen Men
dc.contributor.authorAyoubi, Karim Zen
dc.contributor.authorHarewood, Gavin Cen
dc.contributor.authorPatchett, Stephen Een
dc.contributor.authorMurray, Frank Een
dc.date.accessioned2011-04-06T14:45:02Z-
dc.date.available2011-04-06T14:45:02Z-
dc.date.issued2010-03-
dc.identifier.citationCo-prescription of gastro-protectants in hospitalized patients: an analysis of what we do and what we think we do. 2010, 44 (3):e51-6 J. Clin. Gastroenterol.en
dc.identifier.issn1539-2031-
dc.identifier.pmid19609216-
dc.identifier.doi10.1097/MCG.0b013e3181a9f43b-
dc.identifier.urihttp://hdl.handle.net/10147/127500-
dc.description.abstractProton pump inhibitors (PPIs) reduce the risk of upper gastrointestinal hemorrhage (UGIH) associated with the use of many medications.-
dc.description.abstractTo examine how clinicians perceive such risk and whether PPI co-prescribing is based on an accurate assessment.-
dc.description.abstractClinicians in a single teaching hospital were asked to estimate risk of UGIH and comment on PPI co-prescription in hypothetical patients. Records of 160 hospital in-patients (median age; 74 y) were then reviewed to examine PPI prescribing and risk factors for UGIH.-
dc.description.abstractIn general, clinicians estimated UGIH risk accurately and reported low thresholds for PPI co-prescription. Prescribing records showed regular PPI use increased between admission and discharge of patients from 61/160 (38%) to 93/160 (58%). Ten percent had a prior history of peptic ulcer disease. Proton pump inhibitor prescription was significantly associated with the use of aspirin and clopidogrel. Half of the patients with multiple risk factors for UGIH on admission and almost a third at discharge were not co-prescribed a PPI.-
dc.description.abstractClinicians generally estimate correctly the risk of UGIH and report a low threshold for prescribing gastro-protection. Despite this, prescribing practice does not consistently take account of relative risk of UGIH. Targeted PPI co-prescribing on the basis of risk factors would lead to more rational PPI use.-
dc.language.isoenen
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshAspirin-
dc.subject.meshAttitude of Health Personnel-
dc.subject.meshData Collection-
dc.subject.meshFemale-
dc.subject.meshGastrointestinal Hemorrhage-
dc.subject.meshHospitals, Teaching-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPeptic Ulcer-
dc.subject.meshPhysician's Practice Patterns-
dc.subject.meshPlatelet Aggregation Inhibitors-
dc.subject.meshProton Pump Inhibitors-
dc.subject.meshRisk Factors-
dc.subject.meshTiclopidine-
dc.titleCo-prescription of gastro-protectants in hospitalized patients: an analysis of what we do and what we think we do.en
dc.typeArticleen
dc.contributor.departmentDivision of Gastroenterology and Hepatology, Beaumont Hospital, Royal College of Surgeons, Beaumont, Dublin, Irelanden
dc.identifier.journalJournal of clinical gastroenterologyen
dc.description.provinceLeinster-
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