Evaluation of use of proton pump inhibitors in Greece.

Introduction: Proton pump inhibitors (PPIs) are widely used for acid-related gastric diseases. However, several national studies reported increasing use of PPIs for yet unlicensed indications.

Aim: The aim of our study was to evaluate the extent of PPIs prescription in a Greek tertiary hospital, as well as the adherence to licensed indications according to the Greek National Drug Organization.

Methods: We retrospectively studied the discharge letters of 1693 adult patients who were admitted at the First Propedeutic Department of Internal Medicine at AHEPA hospital in Thessaloniki, Greece between July 2005 and December 2006. We studied their discharge letters in order to record all cases in which antisecretory therapy (PPIs or H(2) antagonists) was prescribed, as well as to collect data about indication of PPI treatment and the type of PPI prescribed for each patient.

Results: PPIs were prescribed in 430 patients (25.4%). In 349 patients, PPIs were prescribed for an improper indication (81.2%), mainly for prophylaxis against medications such as steroids, non-steroidal anti-inflammatory drugs, antiplatelets and warfarin. The most commonly prescribed PPI was omeprazole.

Conclusions: PPIs are inappropriately prescribed in Greece. In most cases, physicians prescribe PPIs for unlicensed indications and usually, they do not give specific instructions about the duration of the treatment.