Evidence map›Paper›PMID 26319396›Full record

Observational studyInternational journal of clinical pharmacy2015

The use of proton pump inhibitors in an Italian hospital: focus on oncologic and critical non-ICU patients.

Maria Meli, Maria Pia Raffa, Renato Malta, Ilaria Morreale, Luigi Aprea, Natale D'Alessandro

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in International journal of clinical pharmacy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Observational
  2. Article
  3. Appropriateness of proton pump inhibitors use in noncritically ill hospitalized children in a tertiary hospital in Saudi Arabia.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2023
    Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Maria MeliClinical Pharmacology Unit, Department of Hospital General Services, Azienda Ospedaliera Universitaria Policlinico "P. Giaccone", via del Vespro 129, 90127, Palermo, Italy. maria.meli@unipa.it.
Maria Pia RaffaClinical Pharmacology Unit, Department of Hospital General Services, Azienda Ospedaliera Universitaria Policlinico "P. Giaccone", via del Vespro 129, 90127, Palermo, Italy.
Renato MaltaDepartment of Biopathology and Medical Biotechnology, University of Palermo, Policlinico "P. Giaccone", via del Vespro 129, 90127, Palermo, Italy.
Ilaria MorrealeClinical Pharmacology Unit, Department of Hospital General Services, Azienda Ospedaliera Universitaria Policlinico "P. Giaccone", via del Vespro 129, 90127, Palermo, Italy.
Luigi ApreaAzienda Ospedaliera Universitaria Policlinico "P. Giaccone", via del Vespro 129, 90127, Palermo, Italy.
Natale D'AlessandroClinical Pharmacology Unit, Department of Hospital General Services, Azienda Ospedaliera Universitaria Policlinico "P. Giaccone", via del Vespro 129, 90127, Palermo, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProton pump inhibitors (PPIs) are among the most misused drugs both at the community and hospital level. Recently, possible risks have been underscored, suggesting the importance of limiting PPI use to proven indications.

objectiveTo survey the appropriateness of PPI use in a University hospital in Italy. Setting Azienda Ospedaliera Universitaria Policlinico 'P. Giaccone', in Palermo, Italy.

methodA one day-observational study, reviewing patients' medical records to identify treatments with PPIs and the indications for their use. After discharge, a subgroup of the cohort was followed up to assess the continuation of therapy at home. Appropriateness was evaluated according to the indications stated in the official product information sheet and supported by the AIFA notes.

main outcome measurePrevalence and appropriateness of PPI use in the hospital and after discharge.

resultsIn the index day 62.9 % of 343 evaluable patients received a PPI. In only 29.1 % of these, the treatment could be considered appropriate. The most frequent reasons for inappropriate treatment were stress ulcer prophylaxis in low risk patients and unwarranted gastro-protection in drug treated patients. 30.9 % of patients received PPIs for uncertain indications: of these, 25.7 % were "critical" patients admitted in non-ICU wards. Furthermore, as much as 88.2 % of anticancer drug treated patients received PPIs as gastroprotective agents. At discharge 48.6 % of patients received a prescription to continue PPI therapy at home and 75.9 % of the 83 followed up patients were found to be still taking these drugs after on average 3 months from discharge.

conclusionThis study confirms a high proportion of inappropriate PPI therapy into the hospital that translates in a prolonged unnecessary administration in the community setting. Further studies are needed to assess the cost-effectiveness of PPI therapy in subgroups of patients at moderate risk for gastric complications to optimize current guidelines.

Indexed as

AdultAgedDrug UtilizationFemaleGuideline AdherenceHospitalizationHospitals, UniversityHumansInappropriate PrescribingItalyMaleMiddle AgedPatient DischargePractice Guidelines as TopicProton Pump InhibitorsStomach UlcerProton Pump InhibitorsDrug utilizationHospitalItalyProton pump inhibitorsTherapeutic appropriateness

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.