Rationale use of proton pump inhibitors: Observational study of hospital based prescriptions and role of clinical pharmacist

Abstract

The rationale of acid suppressant therapy with PPIs was assessed to measure the treatments conformity in PGHI under clinical guidelines. The irrational use of PPIs was found to induce side effects in patients and increased budgetary constraint. In a 4 phase study, 2 groups of patients (784 and 2804) were selected; Pre intervention retrospective review of the prescriptions was done in phase I. Insightful awareness in clinicians and patients was created in phase II a and II b respectively. The ongoing prescriptions were intervened in phase III. The post-intervention retrospective audit of prescription was completed in phase IV. The data was recorded for chronic disease patients in the hospital, revealed a marked reduction (85%) in the frequency of PPI’s prescriptions (784 to 117), Cost of PPI's /year reduced to 19.3% , from US$: 24522/- to US$: 4718/-. The side effects reported in patients’ feedback was also reduced such as hypocalcaemia (59%), hypomagnesaemia (52%), anemia (28%), reflux dyspepsia (82%), C. difficile associated diarrhea (15%), pneumonia (5%), and nephritis in patients with CKD (11%). The intervention induced awareness in Clincians (85%), in patients (38%), reduction in PPIs prescription (45%), whereas cost of PPI’s prescription in group 2 was reduced from US$ 36481/- to US$:10325/- i.e. (28%)