Potentially inappropriate proton-pump inhibitor prescription in the general population: a claims-based retrospective time trend analysis
Background: Proton-pump inhibitors (PPI) are among the most prescribed drugs worldwide, and a large body of evidence raises concerns about their inappropriate use. Previous estimates of inappropriate use varied due to different definitions and study populations. Aims: We aimed to measure the populat...
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Series: | Therapeutic Advances in Gastroenterology |
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doaj-4da78a9cfcfa4250bc2c3dc0a2a12c3b2021-04-16T23:34:57ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482021-04-011410.1177/1756284821998928Potentially inappropriate proton-pump inhibitor prescription in the general population: a claims-based retrospective time trend analysisLeander MuheimAndri SignorellStefan MarkunCorinne ChmielStefan Neuner-JehleEva BlozikPascale UrsprungThomas RosemannOliver SennBackground: Proton-pump inhibitors (PPI) are among the most prescribed drugs worldwide, and a large body of evidence raises concerns about their inappropriate use. Previous estimates of inappropriate use varied due to different definitions and study populations. Aims: We aimed to measure the population-based incidence and time trends of PPI and potentially inappropriate PPI prescriptions (PIPPI) with a novel method, continuously assessing excessive cumulative doses based on clinical practice guidelines. We also assessed association of patient characteristics with PPI prescriptions and PIPPI. Methods: This was an observational study based on a large insurance claims database of persons aged >18 years with continuous claims records of ⩾12 months. The observation period was January 2012 to December 2017. We assessed the incidence and time trends of PPI prescriptions and PIPPI based on doses prescribed, defining ⩾11.5 g of pantoprazole dose equivalents during any consecutive 365 days (average daily dose >31 mg) as inappropriate. Results: Among 1,726,491 eligible persons, the annual incidence of PPI prescriptions increased from 19.7% (2012) to 23.0% (2017), ( p = <0.001), and the incidence of PIPPI increased from 4.8% (2013) to 6.4% (2017), ( p = <0.001). Age, male gender, drugs with bleeding risk and multimorbidity were independent determinants of PIPPI ( p = <0.001 for all). Conclusions: This study provides evidence that one of the most prescribed drug groups is commonly prescribed inappropriately in the general population and that this trend is increasing. Multimorbidity and drugs with bleeding risks were strong determinants of PIPPI. Addressing PPI prescriptions exceeding guideline recommendations could reduce polypharmacy and improve patient safety.https://doi.org/10.1177/1756284821998928 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Leander Muheim Andri Signorell Stefan Markun Corinne Chmiel Stefan Neuner-Jehle Eva Blozik Pascale Ursprung Thomas Rosemann Oliver Senn |
spellingShingle |
Leander Muheim Andri Signorell Stefan Markun Corinne Chmiel Stefan Neuner-Jehle Eva Blozik Pascale Ursprung Thomas Rosemann Oliver Senn Potentially inappropriate proton-pump inhibitor prescription in the general population: a claims-based retrospective time trend analysis Therapeutic Advances in Gastroenterology |
author_facet |
Leander Muheim Andri Signorell Stefan Markun Corinne Chmiel Stefan Neuner-Jehle Eva Blozik Pascale Ursprung Thomas Rosemann Oliver Senn |
author_sort |
Leander Muheim |
title |
Potentially inappropriate proton-pump inhibitor prescription in the general population: a claims-based retrospective time trend analysis |
title_short |
Potentially inappropriate proton-pump inhibitor prescription in the general population: a claims-based retrospective time trend analysis |
title_full |
Potentially inappropriate proton-pump inhibitor prescription in the general population: a claims-based retrospective time trend analysis |
title_fullStr |
Potentially inappropriate proton-pump inhibitor prescription in the general population: a claims-based retrospective time trend analysis |
title_full_unstemmed |
Potentially inappropriate proton-pump inhibitor prescription in the general population: a claims-based retrospective time trend analysis |
title_sort |
potentially inappropriate proton-pump inhibitor prescription in the general population: a claims-based retrospective time trend analysis |
publisher |
SAGE Publishing |
series |
Therapeutic Advances in Gastroenterology |
issn |
1756-2848 |
publishDate |
2021-04-01 |
description |
Background: Proton-pump inhibitors (PPI) are among the most prescribed drugs worldwide, and a large body of evidence raises concerns about their inappropriate use. Previous estimates of inappropriate use varied due to different definitions and study populations. Aims: We aimed to measure the population-based incidence and time trends of PPI and potentially inappropriate PPI prescriptions (PIPPI) with a novel method, continuously assessing excessive cumulative doses based on clinical practice guidelines. We also assessed association of patient characteristics with PPI prescriptions and PIPPI. Methods: This was an observational study based on a large insurance claims database of persons aged >18 years with continuous claims records of ⩾12 months. The observation period was January 2012 to December 2017. We assessed the incidence and time trends of PPI prescriptions and PIPPI based on doses prescribed, defining ⩾11.5 g of pantoprazole dose equivalents during any consecutive 365 days (average daily dose >31 mg) as inappropriate. Results: Among 1,726,491 eligible persons, the annual incidence of PPI prescriptions increased from 19.7% (2012) to 23.0% (2017), ( p = <0.001), and the incidence of PIPPI increased from 4.8% (2013) to 6.4% (2017), ( p = <0.001). Age, male gender, drugs with bleeding risk and multimorbidity were independent determinants of PIPPI ( p = <0.001 for all). Conclusions: This study provides evidence that one of the most prescribed drug groups is commonly prescribed inappropriately in the general population and that this trend is increasing. Multimorbidity and drugs with bleeding risks were strong determinants of PIPPI. Addressing PPI prescriptions exceeding guideline recommendations could reduce polypharmacy and improve patient safety. |
url |
https://doi.org/10.1177/1756284821998928 |
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