Co-prescription of gastro-protectants in hospitalized patients: an analysis of what we do and what we think we do.
Authors
Doherty, Glen ACannon, 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, IrelandIssue Date
2010-03MeSH
AgedAged, 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
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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 gastroenterologyDOI
10.1097/MCG.0b013e3181a9f43bPubMed ID
19609216Abstract
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
ArticleLanguage
enISSN
1539-2031ae974a485f413a2113503eed53cd6c53
10.1097/MCG.0b013e3181a9f43b
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