Are we missing tracks while prescribing proton pump inhibitors? - An opinion from clinicians cross sectional hospital based questionnaire study

Introduction: Poton pump inhibitors are the main stage standard therapy for various gastrointestinal disorders such as upper gastrointestinal disorders, GERD, dyspepsia and peptic ulcer disease.1 The availability of PPIs as an OTC drug and it's over utilization in multiple disease backgrounds with or without symptoms has subjected patients to a potential risk such as parietal cell hypertrophy and hypergastrinemia leading to rebound acid secretion.2 Studies have shown that between 40% to 65% of prescriptions for a PPI fail to have an appropriate indication.3 Inapt stress ulcer prophylaxis (SUP) in hospital wards and in the clinical OPDs, and failure to discontinue SUP prior to hospital discharge has amplified this risk.4 Aim: To analyse the views, opinion and judgement of every clinicians in our hospital regarding PPI prescription and factors they consider while prescribing and their views to decrease misuse of the same. Materials and Methods: This is a cross-sectional, opinion deriving, hospital based questionnaire study where mostly physicians of all specialities were interviewed with a pre-structured questionnaire containing 14 questions. Results: 93 respondents of multi-speciality background had variety of opinion about the practice of the PPIs in our hospital. 24.7% of them treat 31-40 patients per month on average with genuine gastrointestinal symptoms which mandate the use of proton pump inhibitors evidently. 50% of the practitioners told they will prescribe for patient satisfaction and patients request for gastric tablets. 46.7% of the practitioners didn't think of deprescribing PPIs in asymptomatic patients. Nearly 70% of them were either not sure or had any idea about the deprescribing PPI use.