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Observational Study
. 2018 Jul 11;18(1):537.
doi: 10.1186/s12913-018-3358-5.

Changes in proton pump inhibitor prescribing trend over the past decade and pharmacists' effect on prescribing practice at a tertiary hospital

Hongli Luo  1 , Qingze Fan  2 , Shunlin Xiao  2 , Kun Chen  2
Affiliations
Observational Study

Changes in proton pump inhibitor prescribing trend over the past decade and pharmacists' effect on prescribing practice at a tertiary hospital

Hongli Luo et al. BMC Health Serv Res. .

Abstract

Background: Proton pump inhibitors (PPIs) remain one of the world's most frequently prescribed medications and there is a growing number of publications on correct versus incorrect use of PPIs worldwide. The objective of this observational retrospective study was to assess changes in PPI prescribing trends over the past decade and pharmacists' effect on optimizing PPI prescribing practice at a tertiary hospital in China.

Methods: We collected the prescriptions of PPIs in our hospital from January 2007 to December 2016. Then the rate of PPI prescribing, the defined daily doses (DDDs) and expenditures were calculated and plotted to show the change in utilization of and expenditure on PPIs. Reasons behind this change and effect of pharmacists' intervention were evaluated by investigating the rationality of PPI use through sample surveys of patients of pre-intervention (Jul.-Dec. 2015) and post-intervention (Jul.-Dec. 2016).

Results: In outpatient settings, the rate of PPI prescribing remained almost constant, utilization (from 135,808 DDDs to 722,943 DDDs) and expenditure (from 1.85 million CNY to 7.96 million CNY) increased for the past ten years, dominated by oral formulations and rabeprazole. In contrast, in inpatient settings, the rate of PPI prescribing (from 20.41 to 37.21%), utilization (from 132,329 DDDs to 827,747 DDDs) and expenditure (from 3.15 million CNY to 25.29 million CNY) increased from 2007 to 2015 and then decreased, dominated by injection formulations and omeprazole. Pharmacist interventions could significantly promote the rational use of PPIs (44.00% versus 26.67%), decrease PPI use and reduce patients' charges (P < 0.05).

Conclusions: The utilization of and expenditure on PPIs grew due to the increase of patients and irrational use of PPI. Pharmacist interventions help to reduce PPI utilization and expenditure and enhance rationality for inpatients, but much work should be done to regulate injection and originator formulas, and improve the rationality in the future.

Keywords: Drug utilization; Education; Expenditure; Pharmacist intervention; Proton pump inhibitor.

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Conflict of interest statement

Ethics approval and consent to participate

All data collected in our study were obtained all necessary administrative permissions to access and subsequently use.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
The rate of PPI prescribing for outpatients and inpatients from 2007 to 2016
Fig. 2
Fig. 2
Utilization of oral and injectable PPIs for outpatients and inpatients from 2007 to 2016. DDDs, defined daily doses; a outpatients; b inpatients
Fig. 3
Fig. 3
Utilization of the different PPIs (all formulations) for outpatients and inpatients from 2007 to 2016. DDDs, defined daily doses; a outpatients; b inpatients
Fig. 4
Fig. 4
Utilization of PPIs for inpatients from 2007 to 2016 in DDDs/TID. DDDs, defined daily doses; TID, 1000 inhabitants per day
Fig. 5
Fig. 5
Expenditure (CNY) on oral and injectable PPIs from 2007 to 2016. a outpatients; b inpatients
Fig. 6
Fig. 6
Expenditure (CNY) on the different PPIs from 2007 to 2016. a outpatients; b inpatients
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