Appropriate Proton Pump Inhibitor Use Among Older Adults: A Retrospective Chart Review
Appropriate Proton Pump Inhibitor Use Among Older Adults: A Retrospective Chart Review
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DOI：
10.1016/j.amjopharm.2008.12.001
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发表时间：
2008-12-01
期刊：
影响因子：
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通讯作者：
Ross, Joseph S.
中科院分区：
文献类型：
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作者：
George, Claudene J.;Korc, Beatriz;Ross, Joseph S.
背景：质子泵抑制剂（PPI）应用广泛，但适应症不明确。非适应症使用是特别关注的老年人，谁可能有多种合并症，并采取更多的药物，增加他们的风险，为不良药物reactions.Objective：本研究探讨了适当的PPI使用在门诊老年人的做法和特定的患者特征之间的关联，并适当使用这些药物。这是一项对一组随机确定的年龄≥ 65岁的社区居住成年人的回顾性图表审查，这些成年人目前正在接受PPI处方（截至2006年8月）从所有城市学术医疗中心的老年门诊护理实践。主要结果是适当的PPI的使用，分类为指示，可能指示，或不指示，根据美国食品和药物管理局批准的适应症和国家gastroenterology guidelines.Results：出类似的2500例患者在老年人的做法，702（类似28%）被确定为具有目前的PPI处方。从中随机选择了110份图表进行审查，其中10份根据预定义的标准被排除。样本为79%女性和46%白色，平均年龄为82.8岁（范围：66-99岁）。这些患者中有64%有PPI使用指征，7%可能有指征，29%无指征。与PPI的适应症使用相比，非适应症使用与PPI的使用显著相关。
Background: Proton pump inhibitors (PPIs) arc widely used, but not always with a clear indication. Nonindicated use is of particular concern among older adults, who may have multiple comorbidities and take more medications, increasing their risk for adverse drug reactions.Objective: This study examined the appropriateness Of PPI use at an outpatient geriatric practice and the association between particular patient characteristics and appropriate use of these medications.Methods: This was a retrospective chart review of a group of randomly identified community-dwelling adults aged >= 65 years with a current prescription for a PPI (as of August 2006) from a geriatric ambulatory care practice within all urban academic medical center. The main outcome was appropriateness Of PPI use, categorized as indicated, possibly indicated, or not indicated, based on US Food and Drug Administration-approved indications and national gastroenterology guidelines.Results: Out of similar to 2500 patients in the geriatric practice, 702 (similar to 28%) were identified as having a current prescription for a PPI. From these, 110 charts were randomly selected for review, of which 10 were excluded based on predefined criteria. The sample was 79% female and 46% white, with a mean age of 82.8 years (range, 66-99 years). PPI use was indicated in 64% of these patients, possibly indicated in 7%, and not indicated in 29%. Compared with indicated PPI use, nonindicated use was significantly associated with use for