Prescription-indication of proton pump inhibitors: Cost of inadequate prescription in a frst level institution in Colombia
Melissa Hiromi Emura-Vélez, Melissa Aguirre-Cardona, Diana María Cardona-Echeverri, Manuela Alejandra García-Maurno, Diego Arturo García-Ospina, Eliana Andrea Gutiérrez-Osorio, Juan Daniel Castrillón-Spitia
Introduction: Proton Pump Inhibitors (PPIs) are anti-ulcer drugs that have presented patterns of use different from those authorized, which is why it was sought to determine the prescription indication of PPIs in a first-level institution in La Virginia, Risaralda as well as the cost of inadequate prescription. Design: prescription-indication study of medication.
Methods: study of prescription-indication in patients older than 18 years with formulation of a PPI attended at the San Pedro and San Pablo Hospital of La Virginia, Risaralda, between July 1, 2016 and July 31, 2017. A proportional simple random sample was obtained. The clinical histories were used as a unit of analysis. Sociodemographic variables, comorbidities, prescription-indication patterns and polypharmacy were included. Adequate prescription-indication of PPI was defined according to the latest available scientific evidence. Epiinfo 7.2 was used to perform descriptive statistics, X2 and a binary logistic regression (P <0.05). For the cost analysis, reference cost per unit of IBP and DHD x 1000 inhabitants/day was defined. It had bioethical approval.
Results: 317 patients were analyzed, of which 65.6% were women. Omeprazole was the most frequent PPI prescribed (93.7%). An inadequate prescription was presented in 46.3% of the patients, being the emergency service the one with the highest inadequate prescription presented (53.1%). The main diagnoses associated with the inappropriate indication of PPI were arterial hypertension (10%) followed by diabetes (6.0%). Seven variables were associated with a higher probability of presenting an adequate prescription of a PPI. The estimated annual cost for inadequate prescription of PPI was COP $446 602 606 DHD x1000 inhabitants/year.
Conclusions: a high proportion of inadequate prescription of PPIs is described in the population of a first level of care, representing a high cost for the hospital center
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