Attitudes towards use of proton pump inhibitors among geriatricians in Italy

Eur Geriatr Med. 2019 Oct;10(5):827-831. doi: 10.1007/s41999-019-00217-w. Epub 2019 Jul 17.

Abstract

Background/objectives: Proton pump inhibitors (PPIs) are among the most commonly used drugs in the Italian older population. The study aimed to identify prescribing behaviours related to PPIs in Italian geriatricians, and assess their knowledge of prescription appropriateness, potential drug interactions and contraindications.

Design and setting: Survey conducted among geriatricians in Italy.

Participants: A total of 144 geriatricians from acute hospital wards (n = 68, 47.2%), specialist healthcare clinics (n = 22, 15.2%), rehabilitation wards (n = 19, 13.2%), residential care homes (n = 19, 13.2%) and outpatient clinics (n = 16, 11.1%) participated.

Measurements: The self-administered survey included several vignettes on the use of PPIs with accompanying questions that the physicians could reply to with multiple-choice questions.

Results: The geriatricians generally had a good level of knowledge on the risks of PPI and appropriate prescribing techniques. However, there were variations in the responses. Approximately half (52.1%) of physicians suggested that they would consider prescribing a PPI to an older patient taking low-dose acetylsalicylic acid, whereas a third (36.8%) did not. There were different responses concerning which clinical factors potentially limit PPI prescription; many geriatricians (75%) mentioned malnutrition and malabsorption but fewer (27.1%) listed gastric polyps.

Conclusion: There are variations in knowledge and prescribing behaviours for PPIs between geriatricians in Italy. Guidelines are needed for the prescription and monitoring of PPIs in older persons to help geriatricians to increase appropriate prescribing of these drugs.

Keywords: Appropriate prescribing; Elderly; Geriatricians; PPI; Proton pump inhibitors.