Trends, utilisation and appropriateness of proton pump inhibitor prescriptions among recent initiators: a decade-long analysis of patients with a 1-year washout period (2013-2021)
Abstract
Objective: To describe temporal trends in initiation, dose intensity, utilisation and potentially inappropriate prescribing of proton pump inhibitors (PPIs) among recent initiators in an urban Chinese outpatient setting.
Design: Retrospective, annual identification of recent PPI initiators using a 1-year washout definition (repeated cross-sectional approach).
Setting: Outpatient prescriptions recorded in the hospital information system of Jinshan Hospital Affiliated to Fudan University, Shanghai, China, 2013-2021.
Participants: Adults aged ≥18 years who initiated PPI and had no PPI prescription in the preceding year.
Outcome measures: Primary and secondary outcome measures annual initiation rates (overall and stratified by sex, age group, dose intensity and indication), utilisation metrics (defined daily dose/1000 inhabitants/day, defined daily cost, drug utilisation index) and components of potentially inappropriate prescribing (indication-related, prophylaxis-related and incomplete diagnosis).
Results: Among 114 241 recent initiators (mean age 48.47 years; 51.43% female), initiation rates increased from 1.79% (95% CI 1.76% to 1.83%) in 2013 to 2.79% (2.74% to 2.83%) in 2021 (p<0.001), with the steepest rise in adults aged 18-34 years. High-dose initiation peaked in 2019 and then declined, while standard-dose initiation increased after 2019. Across 2013-2021, potentially inappropriate indication-related prescribing decreased (30.94% in 2013 to 10.36% in 2021), whereas…
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Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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