Proton pump inhibitors are among the most prescribed drugs in Slovenia. Even though they are usually indicated for short-term, they are often used for prolonged periods.
The aim of the study was to describe the characteristics of proton pump inhibitor use prior to hospital admission and at discharge, and to evaluate its appropriateness according to treatment guidelines. This observational study included adult medical patients hospitalised at the Univerity Clinic Golnik. Drug history and medical history were obtained through interviews with patients and from the hospital information system.
The study included 382 patients, of which 181 (47,4 %) were using proton pump inhibitors prior to hospital admission. Most were prescribed pantoprazole (71,8 %), often in high doses (53,0 %), with most of patients using proton pump inhibitors regularly (81,8 %). Among the indications for proton pump inhibitors’ use were chronic treatment with nonsteroidal anti-inflammatory drugs (41,4 %) and gastroesophageal reflux disease (32,0 %). Proton pump inhibitors’ use prior to hospital admission was concordant with treatment guidelines in only 57 patients (31,5 %), often due to prolonged use for gastroesophageal reflux disease and use of doses, higher than recommended, in chronic nonsteroidal anti-inflammatory drugs users. Therapy with proton pump inhibitors was changed during the hospitalization in 77 patients (20,2 %), often due to initiation of proton pump inhibitor therapy in 46 patients (12,0 %). In patients in which therapy with proton pump inhibitors changed, this was concordant with treatment guidelines in 41 patients (53,2 %). Overall, at hospital discharge, therapy with proton pump inhibitors was concordant with treatment guidelines in 79 patients (36,6 %).
Almost half of hospitalized adult medical patients used proton pump inhibitors prior to admission, their use not being concordant with treatment guidelines in the majority of patients. To improve use of proton pump inhibitors, the indication for their use should be clearly documented, their effectiveness and the need for continuous therapy should be evaluated regularly.