Appropriateness of Proton pump inhibitor (PPI) recommendation in discharge letters of a gastroenterological department].

Wolfgang Fischbach, Beate Hünger, Matthias Hünger

Zeitschrift fur Gastroenterologie 2022 Jul

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Proton pump inhibitors (PPI) are one of the most often prescribed drugs worldwide. They were thought to have a great safety profile before adverse effects in case of long-term medication were discussed recently. Undoubtedly, the use of PPI has to be based on a clear indication. In this retrospective analysis, we investigated the number of patients being discharged from a gastroenterological department with a PPI medication. We also analyzed if this recommendation was based on an established indication and if dose and duration of therapy were correct. 1612 discharge letters from the period January 1st to June 30th 2011 were evaluated. Patients being discharged with a recommendation of PPI use were assigned to one of four groups: (1) PPI recommendation correct according to guidelines indication, dose and duration of treatment; (2) PPI recommendation correct according to guidelines indication, but with failing or false dose or duration of treatment; (3) PPI recommendation rational but not based on guidelines; (4) Failing indication, wrong recommendation. For a more detailed analysis the patients of group 1 to 4 were then assigned to various subgroups according to comorbidities and concomitant medication. 808 of 1612 discharge letters (50,1%) recommended a PPI use. Assignment to the four groups were as follows: (1) n=344 (42,6%); (2) n=115 (14,2%); (3) n=159 (19,7%); (4) n=190 (23,5%). At time of discharge, PPI are frequently and partially uncritically recommended. Therefore, there is a need for a more intensive education of training interns and for a more critical review of the discharge letters by senior physicians. Even in case of optimal realization of these needs about 20% of debatable recommendations are not based on current guidelines. Thieme. All rights reserved.

Citation

Wolfgang Fischbach, Beate Hünger, Matthias Hünger. Appropriateness of Proton pump inhibitor (PPI) recommendation in discharge letters of a gastroenterological department]. Zeitschrift fur Gastroenterologie. 2022 Jul;60(7):1095-1103