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Prevalence and associations of the use of proton-pump inhibitors in nursing homes: a cross-sectional study

Philipe de Souto Barreto, Maryse Lapeyre-Mestre, Céline Mathieu, Christine Piau, Catherine Bouget, Françoise Cayla, Bruno Vellas, Yves Rolland
Journal of the American Medical Directors Association 2013, 14 (4): 265-9
23211534

OBJECTIVES: Very scarce information is available about the use of proton-pump inhibitors (PPI) in nursing homes (NH). This study investigated the factors associated with PPI use among NH residents.

DESIGN: Cross-sectional

SETTING: One hundred seventy-five NHs in Midi-Pyrénées region, South-Western France.

PARTICIPANTS: Data was collected for 6275 NH residents. Participants (73.7% women) were aged 86 years (± 8.2).

MEASUREMENTS: NH staff sent participants' drug prescriptions to research team; they also recorded information on residents' health characteristics. A binary logistic regression was performed on PPI use.

RESULTS: PPI use was highly prevalent (n = 2 370, ie, 37.8%). Whilst peptic ulcer (OR 4.741; 95% CI 3.647-6.163) and nonsteroidal anti-inflammatory drugs (OR 2.124; 95% CI 1.528-2.951) were important indicators of PPI use, they explained just a small fraction of PPI prescriptions; most prescriptions were probably inappropriately related to a general condition of health vulnerability, reflected by polypharmacy and comorbidities.

CONCLUSIONS: Vulnerable people take PPIs more often in NHs. Physicians must be aware about the health risks possibly induced by inappropriate PPI use when prescribing these drugs for NH residents.

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