Inappropriate proton pump inhibitor lansoprazole prescription in older adults hospitalized in long-term care unit

Ir J Med Sci. 2023 Aug;192(4):1661-1664. doi: 10.1007/s11845-022-03207-3. Epub 2022 Nov 4.

Abstract

Purpose: We evaluated the use of the PPI treatment by physicians in older adults hospitalized in a long-term care unit.

Methods: We included 40 patients aged 65 years or older with a lansoprazole prescription hospitalized in long-term care unit from January 2018 to January 2022. Patient characteristics, gastroduodenal history, dose of lansoprazole, indication, days of prescription, and number of medications were collected from electronic patient records.

Results: The mean age of patients was 84.2 ± 9.3. Patients were taking between 5 and 24 (mean = 12.7, SD = 4.4) medications overall with 15 patients taking low dose of aspirin (75 mg daily) and 8 patients taking an antiplatelet. Most patients (82.5%) received once-daily lansoprazole treatment, 55% of whom took a dose of 15 mg. Five patients were treated with the maximum dose of lansoprazole 30 mg twice daily. Only seven patients had an appropriate indication. The minimum of treatment time was 3 days and the maximum was 1198 days; moreover, 24 patients (60%) were still in treatment.

Conclusion: Few PPI prescriptions had an indication in the patient's electronic record. Prescriptions were ongoing with no date of discontinuation or re-evaluation.

Aim: To evaluate the lansoprazole prescription in older adults hospitalized in long-term care unit.

Findings: In our study population of 65 years or more, the prevalence of appropriate prescription was 17.5% with mean of medications at 12.7 (SD = 4.4). The treatment time was ranging from 3 to 1198 days with 24 patients (60%) still in treatment.

Message: Regular reassessment and the implementation of PPI prescription recommendations were still not routinely used in clinical practice.

Keywords: Inappropriate prescribing; Long-term care; Medication; Older adults; Proton pump inhibitor.

MeSH terms

  • Aged
  • Aspirin
  • Humans
  • Inappropriate Prescribing
  • Lansoprazole / therapeutic use
  • Long-Term Care*
  • Proton Pump Inhibitors* / therapeutic use

Substances

  • Proton Pump Inhibitors
  • Lansoprazole
  • Aspirin