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Overutilization of Anti-Secretory Drugs: A Cause of Concern

Author(s): Yogita S Karandikar, Vaibhav Hanumant Khutle, Anagha Dhore, Shreyash Madankar, Nishant Tangadi, Rohan Bhagat

Introduction: Drug utilization research studies are effective tools that help in evaluating the drug prescribing trends, efficiency of hospital formularies. The use of the gastro protective drugs has been growing rapidly and many drug utilization studies have identified overutilization of PPIs at various centres, especially in the developed countries. This study is designed to identify such problems. Methods: Prospective observational drug-utilization study of gastro protective drugs was conducted for two months in the inpatients of tertiary care Hospital. The case sheets of the patients were reviewed for gastro protective drugs prescription and relevant data was taken. A Validated Frequency Scale for the Symptoms of GERD Questionnaire (FSSG) having 12 items for gastrointestinal symptoms was used for evaluating symptoms score for assessing gastrointestinal symptoms of patients and efficacy of anti-ulcer agents. Results: Pantoprazole was prescribed in majority of cases 68.5% followed by Ranitidine (31.5%). The incidence of polypharmacy was high, average number of drugs per prescription was 6.35. Only 36% prescriptions had an adequate indication for these drugs. 33% patients had gastrointestinal symptoms (FSSG score) >8, whereas average total FSSG score of all patients was 6.35 Antimicrobials and NSAIDS were the most common drugs used concomitantly. It was inappropriately prescribed with NSAIDs in 90% patients and in 53.5% patients with antimicrobial agents. There were 21 prescriptions in which there was possibility of drug interactions. Conclusion: Inappropriate use of PPI remains common in hospital practice. The risks associated with long-term use of PPI like interference with vitamin B12 absorption, increased risk of super-infections, osteoporosis must be weighed against the benefits.

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