Another Study Points to Proton Pump Inhibitor Overprescribing

Published on June 21, 2019 by Sandy Liebhard

A new study conducted by a group or Irish researchers is the latest to suggest proton pump inhibitors, such as Nexium, Prilosec, and PrevAcid, are frequently overprescribed and used inappropriately.

How the Proton Pump Inhibitor Study was Conducted

According to a paper that appeared last month in the Irish Medical Journal, the study authors audited the medical records of 89 adult patients who had been admitted to two general surgical wards or the intensive care unit at Wexford General Hospital over a four-month period.

Their average age was 62 (range 19-96), with 52% aged 65 and over. Most patients were receiving care on a general surgical ward (96%), while four had been admitted to the ICU.

The audit revealed that 73% of the patients were taking proton pump inhibitors. More than half had been prescribed the heart burn drugs after being admitted, while 45% were using the medications prior to their arrival at the hospital.

Just over 72% of the patients were taking Nexium, while 23.1% were taking PrevAcid. The remaining had been prescribed either Prilosec or Protonix.

30% of Proton Pump Inhibitor Scripts Medically Justified

Proton pump inhibitors are considered appropriate for patients suffering from certain digestive disorders caused by the excess production of stomach acid, such as peptic ulcers and GERD. Doctors may also prescribe the drugs as a preventative for those at risk for GI bleeding.

Yet only about 30% of the proton pump inhibitor patients involved in the Irish audit had a documented indication in line with current prescribing guidelines.

Unfortunately, this is not the first study to point to frequent proton pump inhibitor overprescribing.  In fact, a second study examining proton pump inhibitor use at a medical center in Drogheda found that 40% of prescriptions lacked an appropriate indication.

Prior research has also suggested that proton pump inhibitor overprescribing occurs in 70% of cases, with many patients taking the drugs longer than recommended or in the absence of a true medical need.

Risks of Proton Pump Inhibitor Overprescribing

The overuse of proton pump inhibitors needlessly places patients at risk for serious, and even life-threatening, side effects.

Among other things, research suggests long-term proton pump inhibitor use may increase the likelihood of serious kidney complications, including chronic kidney disease, acute kidney injury, acute interstitial nephritis, and kidney failure.

Other studies have linked extended use to a higher risk of gastric cancer, certain type of bone fractures, dementia, heart attacks, B12 deficiency, and low magnesium levels.

Most recently, researchers at the Washington University School of Medicine in St. Louis warned that long-term proton pump inhibitor use, even at low doses, may increase the risk of premature death from heart disease, chronic kidney disease, and stomach cancer.