Hospital Pharmacist
2008;15:4
January 2008

News summary

PPIs are overprescribed in the NHS, say experts

Proton pump inhibitors are overprescribed by NHS doctors to treat indigestion, experts say.

Ian Forgacs, consultant gastroenterologist at King’s College Hospital, London, suggests that 25–70 per cent of patients taking PPIs have no appropriate indication for doing so (BMJ 2008;336:2–3). This results in at least £100m of the NHS drug budget being unnecessarily spent on PPIs every year.

He also suggests that while it is easy to assume that the overprescribing occurs in primary care, research suggests that 67 per cent of UK hospital inpatients who are prescribed PPIs do not have a recognised indication for taking them.

Daniel Greer, gastroenterology pharmacist at Leeds Teaching Hospitals NHS Trust, said that the root of the problem in hospitals was ensuring that the prescribing doctor endorsed all PPI prescriptions with a suggested course length and review date.

“In most cases, the PPI will only be required for a month. It is important that this information is recorded at the time of initial prescribing and also written on the discharge letter to inform the GP.”

However, Mr Greer added that because of the drugs’ high safety profile, this does not always happen. “On the ward, I would strive to ensure that this information is included on a discharge prescription during my clinical check.

However, if the prescription is clinically checked in the dispensary, the checking pharmacist may not have sufficient time to pursue this information,” he said.