Proton pump inhibitors – over-prescribed in a rural community?

Abstract

Objectives: There are specific licensed indications for the use of Proton Pump Inhibitors (PPIs). However it is over-prescribed globally. We performed a study to find out the uses and misuses of this expensive drug in our rural and financially poor population.
Methodology: Prospective survey of patients successively admitted in medical and surgical wards of a teaching hospital in rural setting.
Results: Two hundred fifty successively admitted patients over a month were interviewed. Of them 144 (58%) were females. Mean age was 42 years (range = 10 - 100 years). Ninety (36%) were using PPIs for which there was a licensed clinical indication in 44 (49%), whereas 46 (51%) had no definite indications. Fifty three patients (59%) who were taking PPIs were either self prescribing or were prescribed by an unqualified medical practitioner. Of these, 34 (64%) did not appear to have a valid indication. Of the remaining, 15 patients were prescribed PPI by a specialist, and 22 by a qualified general practitioner.
Conclusions: Over half of patients (51%) in our setting are using PPIs with no definite indication. Over 2/3 (64%) of those were prescribed either by unqualified practitioner or bought over-the-counter, had no licensed indication.