Improper use of antisecretory drugs in a tertiary care teaching hospital: an observational study.

BACKGROUND Antisecretory drugs (ASDs) are prescribed for preventing and treating nonsteroidal, antiinflammatory drug (NSAID)-induced gastrointestinal adverse effects and for stress ulcer prophylaxis (SUP). The suitability of long-term use of ASDs has been evaluated elsewhere but not in the Kingdom of Saudi Arabia (KSA). OBJECTIVES To evaluate the improper use of pantoprazole, a proton pump inhibitor (PPI) and ranitidine, a histamine 2 (H2) receptor antagonist (H2RA); and to identify the associated factors for misuse of these two drugs at a referral hospital. MATERIALS AND METHODS In 2006, a study was carried out at a tertiary care teaching hospital in Riyadh, where patients' medical charts were evaluated for two months. All hospitalized patients on ASDs drugs, aged 18 and above were identified. A standard criterion for proper use of ASDs was applied during evaluation. RESULTS Of the 661 patients studied, the use of ASDs was more significant among males (57.9%) as compared to females. Proper use of ASDs show a significant increasing trend with patients' age. The use of ranitidine (56%) was significantly higher than that of pantoprazole (44%). The unjustified use of the drugs was observed in 282 (43%) patients. Improper use of the drugs decreased as duration of hospital stay lengthened. Two departments, namely medicine and surgery, were significantly associated with the prescription of the two drugs. Higher numbers of improper prescriptions of these drugs were associated with the surgery department (49.3%) than with the medicine department (38.2%). CONCLUSION Improper use of ASDs was observed in 43% of the patients. Based on the results of this study, correct measures need to be implemented in order reduce the misuse of ASDs.