Are the deprescribing guidelines for proton pump inhibitors in palliative care applicable? A monocentric observational study.

Autor:	Evin A; CHU de Nantes, Service de soins palliatifs et de support, Nantes Université, Nantes, France adrien.evin@chu-nantes.fr.; INSERM UMR 1246 SPHERE, Nantes Université, Nantes, France., Denis C; CHU de Nantes, Service de soins palliatifs et de support, Nantes Université, Nantes, France., Nizet P; INSERM UMR 1246 SPHERE, Nantes Université, Nantes, France.; CHU de Nantes, Pharmacie, Nantes Université, Nantes, France., Denis R; CHU de Nantes, Service de santé publique, Nantes Université, Nantes, France., Lannes M; CHU de Nantes, Service de santé publique, Nantes Université, Nantes, France., Victorri-Vigneau C; INSERM UMR 1246 SPHERE, Nantes Université, Nantes, France.; CHU de Nantes, Centre d'évaluation et d'information sur la pharmacodépendance-addictovigilance, Nantes Université, Nantes, France., Huon JF; INSERM UMR 1246 SPHERE, Nantes Université, Nantes, France.; CHU de Nantes, Pharmacie, Nantes Université, Nantes, France.
Jazyk:	angličtina
Zdroj:	BMJ supportive & palliative care [BMJ Support Palliat Care] 2024 Jan 08; Vol. 13 (e3), pp. e928-e932. Date of Electronic Publication: 2024 Jan 08.
DOI:	10.1136/spcare-2023-004542
Abstrakt:	Objectives: Proton pump inhibitors (PPIs) are among the most commonly prescribed medications. The aim of this study was to assess the appropriateness of prescribing PPIs in the palliative care unit on admission and during hospitalisation to determine the applicability of deprescribing recommendations. Methods: A monocentric observational study was conducted over a 6-month period in 2020 in a university palliative care unit. Data on indication, starting date, dose and posology were collected at discharge from the medical record and by contacting the prescriber. A physician and a pharmacist evaluated PPI prescription appropriateness according to guidelines. Results: 131 patients (mean age: 69.5 years; 82% with cancer) were included. Prior to admission, 41% (54/131) of patients were already prescribed PPIs. During hospitalisation, 50% of prescriptions were discontinued, while 12% were initiated. The indication was known for 50% of patients on admission and 59% during their stay. Among patients with PPI prescriptions, 56% had a relevant indication on admission, and 63% during their stay. The prevalence of potential drug interactions was low (<1/10). Conclusions: While PPIs remain essential for specific indications, this study highlights their excessive prescription even during palliative care. Implementing deprescribing recommendations in this population is crucial to optimise treatment plans. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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