Educational intervention can cut inappropriate PPI prescriptions

(HealthDay)—A monthly educational intervention paired with a web-based quality improvement tool is feasible for increasing the proportion of inappropriate proton pump inhibitor (PPI) prescriptions discontinued at hospital discharge, according to a study published online Feb. 24 in the Journal of Hospital Medicine.

Emily G. McDonald, M.D., from the McGill University Health Center in Montreal, and colleagues conducted a before-after study involving a monthly educational intervention paired with a web-based quality improvement tool to reduce inappropriate PPI prescriptions. Data were compared for 464 consecutively admitted patients in the pre-intervention control group and 640 consecutively admitted patients in the intervention group.

The researchers found that before hospitalization, 44 percent of patients were using a PPI. Only 54 percent of evaluated patients had an evidence-based indication for ongoing use. There was an increase in the proportion of PPIs discontinued at hospital discharge, from 7.7 percent per month in the six months before the intervention to 18.5 percent per month post-intervention (P = 0.03).

"We significantly reduced discharge prescriptions for PPIs through the implementation of an educational initiative paired with a web-based quality improvement tool," the authors write. "An active interventional strategy is likely required considering the increasingly recognized and preventable adverse events associated with PPI misuse."