Abstract
The purpose of this study was to describe the proportion and the factors associated with proton pump inhibitors (PPIs) overutilization in non-intensive care unit patients (ICU) at a community teaching hospital. A retrospective chart review was done of patients admitted to non-ICU medical floors at Piedmont Columbus Regional (PCR) with an order for a PPI between June 2016 and May 2017. Data for one hundred and thirty patients were reviewed. Most patients were female [72(55.4 %)], African American [69(53%)], with mean age +/- SD = 57.7 +/- 183 years. Heparin was the most common medication used with PPI [61(46.9%)]. Stress ulcer prophylaxis (SUP) was the major PPI indication [88(68 %)], and primary care providers represent [54(41.5 %)] of PPI prescriptions. Overall, PPIs were found to be inappropriately prescribed in [71(54.62%)]. Only [24(27 %)] of SUP prescriptions were appropriate, and [64 (72.73 %)] of those prescriptions were inappropriate. Age 60 years or older, aspirin use, admitting under family medicine, and having a high score in the Charlson Comorbidity Index (CCI) (>= 4) were associated with an appropriate increase utilization of PPI. The estimated cost of PPI overutilization per year exceeded $ 66,000. Continuation rate of PPI after discharge was [20 (6.6 %)], which has > $1 million outpatient cost annually. Inappropriate utilization of PPIs is a significant issue in inpatient settings, and SUP is the driving force for this overutilization. Providing education to medical staff could result in more judicious and cost-effective use of PPIs.