Key result
Cardiac diseases (OR 4.17), metabolic diseases (OR 2.14), and corticosteroid use (OR 5.39) were significantly associated with overprescription of proton pump inhibitors in older hospitalized patients.
Why the study?
Are specific multimorbidities associated with the overprescription of proton pump inhibitors in older hospitalized patients?
Observational (n=280)
Yes
Are specific multimorbidities associated with the overprescription of proton pump inhibitors in older hospitalized patients?
Effect estimate: OR 4.17 (95% CI 1.41-12.38)
p-value: p=0.010
In older hospitalized patients, overprescription of proton pump inhibitors is highly prevalent and significantly associated with the presence of cardiac and metabolic diseases.
Cardiac and metabolic diseases may flag PPI overprescription risk in older inpatients; hypothesis-generating and requires prospective validation before guiding practice.
OBJECTIVES: To determine whether there is an association between overprescription of proton pump inhibitors (PPIs) and multimorbidities in older patients. DESIGN: Multicenter prospective study. SETTING: Acute geriatric medicine at the University Hospital of Nantes and the Hospital of Saint-Nazaire. PARTICIPANTS: Older patients aged 75 and over hospitalized in acute geriatric medicine. MEASUREMENTS: Older patients in acute geriatric medicine who received proton pump inhibitors. Variables studied were individual multimorbidities, the burden of multimorbidity evaluated by the Cumulative Illness Rating Scale, age, sex, type of residence (living in nursing home or not), functional abilities (Lawton and Katz scales), nutritional status (Body Mass Index), and the type of concomitant medications (antiaggregant, corticosteroids', or anticoagulants). RESULTS: Overprescription of proton pump inhibitors was found in 73.9% older patients. In the full model, cardiac diseases (odds ratio [OR] = 4.17, p = 0.010), metabolic diseases (OR = 2.14, p = 0.042) and corticosteroids (OR = 5.39, p = 0.028) were significantly associated with overprescription of proton pump inhibitors. Esogastric diseases (OR = 0.49, p = 0.033) were negatively associated with overprescription of proton pump inhibitors. CONCLUSION: Cardiac diseases and metabolic diseases were significantly associated with overprescription of proton pump inhibitors.
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Delcher et al. (2015) conducted an observational in Older patients hospitalized in acute geriatric medicine receiving proton pump inhibitors (n=280). Proton pump inhibitors was evaluated on Overprescription of proton pump inhibitors associated with cardiac diseases (OR 4.17, 95% CI 1.41-12.38, p=0.010). Cardiac diseases (OR 4.17), metabolic diseases (OR 2.14), and corticosteroid use (OR 5.39) were significantly associated with overprescription of proton pump inhibitors in older hospitalized patients.
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