Proton pump inhibitors (PPIs) are the most effective agents for treating acid related gastrointestinal (GI) disorders. The utilization of intravenous (IV) formulations of PPIs has dramatically increased in health care institutions for inappropriate indications, route of administration and length of treatment. This is associated with an increased cost burden, increased risk of IV related infections, and utilization of hospital resources.
A research team from Lebanon assessed the clinical and cost impacts of PPI utilization in hospitalized patients. Their study was published on February 28, 2010 in the World Journal of Gastroenterology.
Their results illustrated that the majority of non-intensive care patients were receiving PPIs for claimed stress ulcer prophylaxis (SUP); of which, less than half met the guideline criteria for SUP indication or for Non-Steroidal-Anti-inflammatory Drugs (NSAIDs)-induced ulcer prophylaxis, while the remaining patients were identified as having an unjustified indication for PPI use. Regardless of the appropriateness of the initial intravenous route of administration, switching patients to the oral form when deemed appropriate was carried out in only one third of patients.
Furthermore, the cost analysis associated with the inappropriateness of the indication for PPI use as well as the route of administration of PPI revealed an unnecessary increase in cost.
The researchers highlighted the importance of implementing restrictions on the use of intravenous PPI in order to improve not only clinical impact but also cost impact.