4259.0: Tuesday, November 14, 2000 - Board 5

Abstract #7900

Utilization review of proton pump inhibitors for the eradication of Helicobacter pylori : Does practice follow clinical guidelines?

Régis Blais1, Pierre Madore2, Nancy Lajeunesse3, and Louise Barnard3. (1) GRIS, University of Montreal, PO Box 6128, Station Centre-ville, Montreal, QC H3C 3J7, Canada, (514) 343-5907, regis.blais@umontreal.ca, (2) Complexe hospitalier de la Sagamie, (3) Régie de l'assurance maladie du Québec

The use of proton pump inhibitors (PPI) has increased considerably in the past few years. Whether all the prescriptions are appropriate is questionable. The main objective of this study was to assess whether the use of PPIs for the treatment of peptic ulcers caused by Helicobacter pylori (H. Pylori) was appropriate according to criteria developed by an expert panel, based on the 1997 Canadian Helicobacter pylori consensus conference guidelines. This population-based retrospective drug utilization review was conducted in the province of Quebec, Canada under the responsibility of the Comité de revue de l'utilisation des médicaments (Provincial Drug Utilization Review Committee). Data came from the Quebec health insurance board (RAMQ). The enrolees are 18 years and older and received at least one prescription of PPI between January 1st 1998 and December 31st 1998. Use was assessed according to five criteria : duration and daily dose of PPI , combination, duration and daily dose of antibiotics. Results showed that use was appropriate in approximately 50% of subjects with H. pylori. Appropriateness was higher among male subjects, those aged 35-64 or treated by gastro-enterologists. Clinical guidelines for the eradication of H. pylori are far from being put into practice. Specific actions are proposed to improve the pharmacotherapy of H. pylori eradication and document the purpose of prescribing PPIs in all other circumstances.

Learning Objectives: 1. Identify the criteria of appropriate use of PPI for the treatment of H pylori 2. State the rate of appropriate use of PPI in the Quebec, Canada population. 3. Determine the subgroups of users and prescribers associated with higher appropriate use of PPI in the Quebec population

Keywords: Prescription Drug Use Patterns,

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA