Frequency of Non-GI Prescriptions of Proton Pump Inhibitors from Academic and Non-Academic Hospitals

Abstract

Objectives: To determine the frequency of non-GI proton pump inhibitor (PPI) prescriptions at discharge and compare prescribing patterns between academic and non-academic hospitals.

Methodology: This cross-sectional study included 768 patients receiving PPI prescriptions from two academic and two non-academic hospitals in Karachi from July 2023 to July 2024. Prescriptions were reviewed against published PPI-use guidelines. Categorical variables were compared using the chi-square test, and regression analysis was used to identify predictors of prescription appropriateness.

Results: Among 768 patients, 384 were from academic and 384 from non-academic hospitals. Overall, 364 (47.4%) PPI prescriptions were for non-GI indications. Non-GI prescriptions were 45.83% in academic hospitals and 48.96% in non-academic hospitals, with no significant difference between groups (p = .386). The multiple regression model was statistically significant, F(13, 754) = 203.23, p < .001, explaining 77.8% of the variance in prescription appropriateness (R2 = .778, adjusted R2 = .774). Gastrointestinal ulcer bleeding prophylaxis (β = .460, p < .001), treatment of symptomatic GERD (β = .357, p < .001), chest pain with negative cardiac and pulmonary work-up suspected to be due to dyspepsia or GERD (β = .277, p < .001), and treatment of NSAID-induced gastric ulcers (β = .268, p < .001) were the strongest clinical predictors.

Conclusion: Non-GI PPI prescriptions were frequent in both hospital types. Prescription appropriateness was associated with clinical, institutional, and departmental factors, supporting regular prescription review, physician education, and guideline-based PPI stewardship.