Monday 15 July 2019

Hospital study warns about the over use of heartburn medication

Maria Pepper

Common drugs used to treat heartburn and ulcers are being inappropriately prescribed to patients undergoing surgery and in general practice, according to two new studies by Irish doctors.

Medical researchers from Wexford General Hospital found that 70% of patients were prescribed proton pump inhibitors (PPI's) which prevent gastrointestinal bleeding, without clinical justification.

A survey of 89 surgical patients in the hospital, showed that 73% of them were on PPI therapy but in only 30% of these cases was the prescription in line with recommended use.

Although the inappropriate use rate of 70% was high, the lead author of the report, Dr. Lauren O'Connell from the Department of General Surgery in Wexford General Hospital, said it was 'in line' with other similar studies.

She described the over use of PPI's in both community and acute hospital settings as 'significant' and called for the ongoing education of non-consultant hospital doctors, with regard to appropriate use.

A similar study, by two GPs, on the use of PPIs at a medical centre in Drogheda, found they were prescribed without clear indication in 40% of cases. The drug type accounted for 20% of all prescriptions issued over a four-week period. The two studies, which were published in the Irish Medical Journal, coincide with publication of a US study warning that the long-term use of PPIs, even in low doses, is associated with an increased risk of premature death.

Researchers from Washington University showed evidence of links between PPIs and the risk of developing fatal conditions like heart disease and stomach cancer.

Dr O'Connell said PPIs have revolutionised the treatment of gastrointestinal disorders, but the prescribing rates are continuing to increase out of proportion to the known prevalence of such conditions.

PPIs accounted for 7% of all prescriptions under the General Medical Scheme in 2016, with current expenditure estimated at over €40m per year. The most common PPI used in Wexford General Hospital is esomeprazole - otherwise known under the brand name Nexium - which is prescribed to 72.3% of patients, even though the HSE recommends lansoparazole.

Dr. O'Connell maintains that the recommendation is primarily mainly on cost, as there is a price differential of €16.72 per pack between the two drugs.

New Ross Standard