Non-guideline-recommended prescribing of proton pump inhibitors in the general population

Abstract

Objectives: To determine the magnitude of non-guideline-recommended prescribing (NGRP) of proton pump inhibitors (PPIs) in the general population, its associated factors and expense.

Methods: We undertook a cross-sectional observational study in three community pharmacies in a Spanish region in 2013 involving a total of 302 patients with a prescription for PPIs. The main variable was the NGRP of PPIs. Secondary variables were: gender, age, antidepressants, osteoporosis, osteoarthritis, prescription cost per month and total number of chronic diseases. The cost associated with NGRP was calculated. To evaluate the associated factors, a multivariate binary logistic regression model was constructed and the adjusted odds ratios (OR) were obtained.

Results: NGRP was observed in 192 cases (63.6%). The average cost associated with NGRP per prescription was 3.24 euros per month. The factors significantly associated with NGRP (p < .05) were: antidepressants (OR = 2.66, p = .001), osteoporosis (OR = 3.53, p = .001), osteoarthritis (OR = 3.57, p < .001) and number of chronic diseases (OR = 0.73, p = .003).

Conclusion: A novel approach was used to quantify the NGRP of PPIs in a Spanish community, as well as the associated economic costs. Qualitative studies are needed to better understand the causes of NGRP of PPIs. This analysis will aid in designing interventions to minimize this problem.

Limitations: Qualitative studies are needed to better understand the attitude of health professionals when prescribing PPIs.

Keywords:

• Guideline adherence
• health services
• prescriptions
• proton pump inhibitors

Transparency

Declaration of funding

Nothing to declare.

Declaration of financial/other relationships

E.M.-G., A.P.-B., Á.M.-M., D.M.F.R., A.P.-R., and V.F.G.-G. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The authors thank Maria Repice and Ian Johnstone for help with the English language version of the text.