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Revista Clínica de Medicina de Familia
versão On-line ISSN 2386-8201versão impressa ISSN 1699-695X
Resumo
AZPIAZU GARRIDO, Mercedes e MUNOZ HERNANDEZ, Isabel S.. Adequacy and safety in Proton Pump Inhibitors (PPIs) chronic use. Rev Clin Med Fam [online]. 2017, vol.10, n.2, pp.70-77. ISSN 2386-8201.
Objective:
To evaluate the adequacy of PPI chronic use, the factors associated to it and the presence of possible adverse effects.
Design:
Retrospective observational study.
Location:
Urban health centre.
Participants:
109 of the 242 patients aged 40 to 85 who consumed PPIs over 12 months in 2013 and 2014.
Main measures:
Sex, age, active ingredient, consumption time (months), indication, current adequacy, comorbidity, chronic treatments and presence of adverse effects. Random sampling from two doctor quotas. Review of medical records.
Results:
Average age: 70.9 (SD: 10.1) years old. Women: 58.7 %. 83.5 % consumed omeprazole. Median consumption time: 96 months (interquartile range: 60-132). PPIs were indicated for gastroprotection (55 % ), GERD (9.2 %) and nothing (35.8 %). Current consumption was appropriate in 64.2 % (37 % in aged <65 vs 73.2 % in aged >65, p=0.001). Average number of comorbidities was 2.3 (SD: 1.1) diseases. Osteoarthritis and depression were more common in women while vascular disease, lung disease and liver disease were more common in men. The average number of chronic medications was 5.7 (SD: 2). Pneumonia (24.8 %), vitamin B12 deficiency (6.4 %) and osteoporosis (31.2 %) were concomitant diseases during PPI consumption. Patients with appropriate PPI chronic consumption were older, had more comorbidities (mainly vascular disease and anxiety-depression), and used more medications (among them, antiplatelet drugs, SSRIs, gastroerosive NSAIDs.
Conclusions:
75 % of the sample showed a PPI chronic use of over 5 years. 35.8 % used PPIs without justified indication. Corrective measures are therefore required to improve patient safety.
Palavras-chave : Proton Pump Inhibitors; Inappropriate Prescribing; Patient Safety.