scholarly journals Who gets prescriptions for proton pump inhibitors and why? A drug-utilization study with claims data in Bavaria, Germany, 2010–2018

2021 ◽  
Author(s):  
Ina-Maria Rückert-Eheberg ◽  
Michael Nolde ◽  
Nayeon Ahn ◽  
Martin Tauscher ◽  
Roman Gerlach ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Claims Data ◽  
Drug Prescription ◽  
Prescribing Practices ◽  
Drug Utilization Study ◽  
Suspected Drug ◽  
Defined Daily Doses ◽  
Utilization Data ◽  
Observation Period

Abstract Purpose The German annual drug prescription-report has indicated overuse of proton pump inhibitors (PPIs) for many years; however, little was known about the characteristics of people using PPIs. This study aimed to provide comprehensive utilization data and describe frequencies of potential on- and off-label PPI-indications in Bavaria, Germany. Methods Claims data of statutorily insured people from 2010 to 2018 were used. Defined daily doses (DDDs) of PPIs by type of drug, prevalence of PPI-use and DDDs prescribed per 1000 insured people/day were analyzed. For 2018, proportions of users and DDDs per 1000 insured people were calculated by age and sex. To elucidate changes in prescribing practices due to a suspected drug-drug interaction, we examined co-prescribing of clopidogrel and PPIs between 2010 and 2018. For PPI new users, sums of DDDs and frequencies of potential indications were examined. Results PPI prescribing increased linearly from 2010 to 2016 and gradually decreased from 2016 to 2018. In 2018, 14.7% of women and 12.2% of men received at least one prescription, and 64.8 DDDs (WHO-def.) per 1000 insured people/day were prescribed. Overall, omeprazole use decreased over the observation period and was steadily replaced by pantoprazole, especially when co-prescibed with clopidogrel. An on-label PPI-indication was not reported at first intake in 52.0% of new users. Conclusions The utilization of prescribed PPIs has decreased since 2016. However, a large proportion of new PPI-users had no documentation of a potential indication, and the sums of DDDs prescribed often seemed not to comply with guidelines.

scholarly journals Association of Increased Risk of Pneumonia and Using Proton Pump Inhibitors in Patients With Type II Diabetes Mellitus

Dose-Response ◽  
2019 ◽  
Vol 17 (2) ◽  
pp. 155932581984338 ◽  
Author(s):  
Wen-Ling Lin ◽  
Chin-Shin Muo ◽  
Wen-Chuan Lin ◽  
Yow-Wen Hsieh ◽  
Chia-Hung Kao
Keyword(s):  
Diabetes Mellitus ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Defined Daily Dose ◽  
Defined Daily Doses ◽  
Increased Risk

Background: This study explored the possible association between the use of proton pump inhibitors (PPIs) and the increased incidence of pneumonia in patients with type 2 diabetes mellitus (T2DM). Methods: We selected 4940 patients with T2DM of whom 988 and 3952 were enrolled in PPI and propensity score-matched control cohorts, respectively. All patients were followed from the index date until admission with pneumonia, withdrawal from the National Health Insurance program or the end of 2013. The PPIs associated with risk of incident pneumonia were examined. Furthermore, we assessed the risk of pneumonia according to annual defined daily doses in the PPI cohort. Results: After a 14-year follow-up, the cumulative incidence of pneumonia in the PPI users was 11.4% higher than that in the controls (30.3% vs 18.9%). Compared to the controls, the PPI users had a 1.70-fold higher risk of pneumonia in the Cox proportional hazards model after adjustment for matched pairs. The risk of pneumonia increased with the annual PPI defined daily dose. Conclusion: The results of this population-based retrospective cohort study suggest that PPI use increased the risk of pneumonia in patients with T2DM. The effects were more prominent in patients administered higher doses of PPIs.

Proton pump inhibitors: why this gap between guidelines and prescribing practices in geriatrics?

2019 ◽  
Vol 75 (9) ◽  
pp. 1327-1329 ◽  
Author(s):  
Hugues Michelon ◽  
A. Delahaye ◽  
L. Fellous ◽  
B. Davido ◽  
A. Dinh ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Prescribing Practices

scholarly journals Proton-pump inhibitors among adults: a nationwide drug-utilization study

2018 ◽  
Vol 11 ◽  
pp. 175628481877794 ◽  
Author(s):  
Óskar Ö. Hálfdánarson ◽  
Anton Pottegård ◽  
Einar S. Björnsson ◽  
Sigrún H. Lund ◽  
Margret H. Ogmundsdottir ◽  
...  
Keyword(s):  
Drug Utilization ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Oral Anticoagulants ◽  
Population Based ◽  
Annual Incidence ◽  
Drug Utilization Study ◽  
Duration Of Treatment ◽  
Entire Study ◽  
Inflammatory Drugs

Background: The use of proton-pump inhibitors (PPIs) has grown worldwide, and there are concerns about increased unsubstantiated long-term use. The aim of the study was to describe the real-world use of PPIs over the past decade in an entire national population. Methods: This was a nationwide population-based drug-utilization study. Patterns of outpatient PPI use among adults in Iceland between 2003 and 2015 were investigated, including annual incidence and prevalence, duration of use, and dose of tablet used (lower versus higher), as well as the proportion of PPI use attributable to gastroprotection. Results: We observed 1,372,790 prescription fills over the entire study period, of which 95% were for higher-dose PPIs. Annual incidence remained stable across time (3.3–4.1 per 100 persons per year), while the annual prevalence increased from 8.5 per 100 persons to 15.5 per 100 persons. Prevalence increased with patient age and was higher among women than men. Duration of treatment increased with patients’ age (36% of users over 80 years remained on treatment after 1 year compared with 13% of users aged 19–39 years), and was longer among those initiating on a higher dose compared with a lower dose. The proportion of PPI users concurrently using nonsteroidal anti-inflammatory drugs decreased over the study period, while the proportion concurrently using acetylsalicylic acid, oral anticoagulants, or platelet inhibitors increased. Conclusions: In this nationwide study, a considerable increase in overall outpatient use of PPIs over a 13-year period was observed, particularly among older adults. Patients were increasingly treated for longer durations than recommended by clinical guidelines and mainly with higher doses.

scholarly journals Description of Prescribing Practices in Patients with Upper Gastrointestinal Bleeding Receiving Intravenous Proton-Pump Inhibitors: A Multicentre Evaluation

2004 ◽  
Vol 18 (9) ◽  
pp. 567-571 ◽  
Author(s):  
Robert Enns ◽  
Christopher N Andrews ◽  
Martin Fishman ◽  
Michael Hahn ◽  
Kenneth Atkinson ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Upper Gastrointestinal Bleeding ◽  
Prescribing Practices ◽  
Clinical Practices ◽  
Ulcer Disease ◽  
Inappropriate Use ◽  
Endoscopic Findings ◽  
Upper Gastrointestinal

BACKGROUND:Intravenous forms of proton pump inhibitors (IV PPI) are routinely used for patients with acute upper gastrointestinal bleeding, but a significant concern for their inappropriate use has been suggested.PATIENTS and METHODS:All consecutive patients who received IV PPI (pantoprazole) over 20 months in six Canadian hospitals were reviewed. Prescribing practices, endoscopic findings and outcomes were recorded.RESULTS:A total of 854 patients received IV PPI. Over 90% of patients were given IV PPI for treatment of known or suspected active upper gastrointestinal bleeding. Most patients (69%) underwent upper endoscopy, and 58% of these patients had peptic ulcer disease (PUD). The majority of patients who had endoscopy (57%) had IV PPI administered in advance of the procedure. Of the 334 patients who had IV PPI given in advance, 46 (13.8%) were found to have high risk bleeding PUD stigmata at endoscopy. The remaining 288 patients (86.2%) with advance IV PPI had low-risk PUD lesions or non-PUD lesions; IV PPI was continued after endoscopy in 164 (56.9%) of these patients.CONCLUSIONS:IV PPI is often used before endoscopy in suspected upper gastrointestinal bleed and maintained, regardless of endoscopic findings, after the endoscopy in many Canadian centres. Further study is required to support these clinical practices.

Use of Proton Pump Inhibitors-A drug utilization study

2016 ◽  
Vol 3 (2) ◽  
pp. 88 ◽  
Author(s):  
Shabbir Rafik Pendhari ◽  
Kedar Shashikant Joshi ◽  
Ramchandra Prabhakar Limaye
Keyword(s):  
Drug Utilization ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Drug Utilization Study

Proton Pump Inhibitors Are Associated with Increased Risk of Psoriasis: A Nationwide Nested Case-Control Study

Dermatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Cheng-Yuan Li ◽  
Ying-Xiu Dai ◽  
Yun-Ting Chang ◽  
Ya-Mei Bai ◽  
Shih-Jen Tsai ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Case Control Study ◽  
Research Database ◽  
Defined Daily Doses ◽  
Increased Risk ◽  
Taiwan National Health Insurance ◽  
Underlying Mechanisms ◽  
Nested Case Control ◽  
Control Study

<b><i>Background:</i></b> Proton pump inhibitors (PPIs) are among the most widely used drugs. Little is known about the association between PPI use and risk of psoriasis. <b><i>Objective:</i></b> To investigate the association between PPI use and subsequent psoriasis risk. <b><i>Methods:</i></b> We included participants from the Taiwan National Health Insurance Research Database. Patients with PPI use and an incidence of psoriasis (<i>n</i> = 5,756) were assigned to the case cohort and 1:1 matched to controls. PPI use was defined as &#x3e;30 cumulative defined daily doses (cDDDs); PPI nonuse was defined as ≤30 cDDDs. Logistic regression was used for the analyses. <b><i>Results:</i></b> There was a significant association between PPI use and psoriasis risk. The confounder-adjusted odd ratios (95% confidence interval [CI]) were 1.52 (1.31–1.76) and 1.54 (1.22–1.93) for patients with 120–365 cDDDs and &#x3e;365 cDDDs, respectively, compared with PPI nonusers. Stratified analyses based on PPI type showed that exposure to lansoprazole (OR, 1.25; 95% CI, 1.11–1.41) was associated with subsequent psoriasis risk. <b><i>Conclusions:</i></b> PPI use might be associated with an increased risk of developing psoriasis or as an epiphenomenon. Further prospective studies are needed to elucidate the association and underlying mechanisms.

Influence of generics in prescribing dynamics of proton pump inhibitors in general practice

2009 ◽  
Vol 10 (1) ◽  
pp. 47-53
Author(s):  
Simona Cammarota ◽  
Anna Citarella ◽  
Enrica Menditto ◽  
Simona De Portu ◽  
Luigi Napoli ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Cost Effective ◽  
Defined Daily Dose ◽  
Annual Growth Rate ◽  
Medical Practitioners ◽  
Compound Annual Growth Rate ◽  
Defined Daily Doses ◽  
Upper Abdominal ◽  
Reimbursement Purpose

Use of antisecretory drugs has greatly increased in recent years in Italy. After the launching of generic lansoprazole (early 2006), several Italian Regional Health Authorities have introduced measures to favour the prescription of less expensive PPI. The aim of this study is to evaluate general practitioners’ prescription (GPs) of different Proton Pump Inhibitors (PPIs) in the period between 2005 to 2008. Analysis has been performed on a database of 99 medical practitioners that have managed an average of 150,000 inhabitants. We evaluate the PPIs prescriptions from Jan 2005 to Dec 2008. Evaluations performed are the following: 1) PPI prescription (total and separately for lansoprazole, esomeprazole, pantoprazole, rabeprazole, and omeprazole); 2) prevalence of the reimbursement purpose (Gastroprotection – G; Acid-Related Disease – ARD); 3) PPI prescriptions separately for ARD diagnostic codes. Data were expressed as Compound Annual Growth Rate (CAGR). PPI consumption were quantified using Defined Daily Dose system (DDD). The total volume of PPI’s prescribing increased progressively over the 4 years (CAGR +15%). The proportion of defined daily doses accounted for by lansoprazole increased from 12.0% in 2005 to 30.9% in 2008. The prescription of omeprazole decreased from 42.2% to 26.7%, while that of esomeprazole remained costant. The reimbursement purpose was higher for G (CAGR +43%) than for ARD (CAGR +7%). We found an increase of lansoprazole prescriptions especially for heartburn (CAGR +52.4%), gastroesophageal reflux (CAGR 34,5%) and upper abdominal pain (CAGR 37,2%). Generic PPIs has unexpectedly increased the prescription of whole drug class during the period 2005-2008. Our data suggest that the appropriateness of PPI prescription after generic PPI introduction should be carefully monitored to distinguish between cost-effective from cost-ineffective PPI treatment.

scholarly journals Drug use for gastrointestinal symptoms during pregnancy: A French nationwide study 2010–2018

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245854
Author(s):  
Antoine Meyer ◽  
Marion Fermaut ◽  
Jérôme Drouin ◽  
Franck Carbonnel ◽  
Alain Weill
Keyword(s):  
Drug Use ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Drug Prescription ◽  
Gastrointestinal Symptoms ◽  
Common Cause ◽  
Nationwide Study ◽  
Risk Benefit Assessment ◽  
The Subject ◽  
Health Database

Purpose To describe drug prescription for gastrointestinal symptoms during pregnancy. Methods Using the French national health database, we identified pregnancies ending with a birth between April 2010 and December 2018, in France. We studied prescription of antacids, antispasmodics, antinauseants, laxatives and antidiarrheals during pregnancy, between two trimesters before and two trimesters after delivery. We also assessed hospitalization for gastrointestinal symptoms during pregnancy. Results Among 6,365,471 pregnancies, 4,452,779 (74.0%) received at least one gastrointestinal drug during pregnancy; 2,228,275 (37.0%) received an antacid, 3,096,858 (51.5%) an antispasmodic, 1,861,731 (31.0%) an antinauseant, 919,116 (15.3%) a laxative and 617,808 (10.3%) an antidiarrheal. Prescription of proton pump inhibitors doubled from 12.2% in 2010 to 26.0% in 2018, while domperidone use decreased from 18.3% in 2010 to 2.2% in 2018. In addition, prescription of antacids increased from 7.0% during the trimester before pregnancy to 11.8% during the 1st trimester, 17.0% during the 2nd trimester and 23.4% during the 3rd trimester. Antispasmodic use was 10.6% during the trimester before pregnancy, 23.1% during the 1st trimester, 25.2% during the 2nd trimester and 24.0% during the 3rd trimester. Prescription of antinauseant drugs increased from 5.0% during the trimester before pregnancy to 25.7% during the 1st trimester, then decreased to 6.4% during the 2nd trimester and 3.2% during the 3rd trimester. Nausea/vomiting was the most common cause of hospitalization for gastrointestinal symptoms or diseases during pregnancy, although it accounted for only 1.0% of pregnancies. Conclusions Approximately three-quarters of women use drugs for gastrointestinal symptoms during pregnancy in France. Prescription of gastrointestinal drugs during pregnancy should be the subject of more detailed risk-benefit assessment and recommendations.

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