Performa Case Study

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INTRODUCTION PPI’s from the 80’s constitute the larger area in one of the most commonly prescribed medicines with a high level of efficacy and low toxicity(1). PPI’s have ruled the areas of prescribing since their advent(2).The first PPI introduced was Omeprazole, which demonstrated to be safe and with good efficacy(2,7).PPI’s are the potent inhibitors of gastric acid secretion by an irreversible inhibition of H+K+ ATPase pump and decrease stimulated and basal gastric acid(3). PPI’s are indicated for as recommended by the established NICE guidelines (2014) update as appropriate PUD, GERD, H.pylori eradication, patients with documented NSAID or aspirin induced ulcers aged 65 and above, Zollinger Ellision Syndrome, high risk of stress ulcers,…show more content…
Patients under 18yrs, pregnant women, lactating mothers and chronically ill were excluded. (Medical wards)The structured Performa consists of patients’ demographic details such as – Name, Age, Sex, DOA, and DOD. Patient’s reason for admission ,history of present illness, past medical and medication history, social history, diagnosis, any investigations done to confirm diagnosis, drug indication, concomitant drugs, duration of treatment, PPI’s given at discharge, other GI drugs(1). The appropriate indications for proton pump inhibitors are as shown in table…show more content…
During the study, the inpatients with PPI prescriptions in the medical ward recruited were 300 in number; their mean age was 47.2years and 180(60%) were female. Demographic data of study population were as shown in table 2. The patients with past history of PPIs and duration of treatment were as shown in figure1.The PPI prescriptions with appropriate indications were Gastro-oesophageal reflux disease (4%), oesophagitis (1%), H.pylori eradication(1%), Peptic ulcer disease (2%), acute gastritis(11%), Acute gastroenteritis(19%), Acid peptic disease(12%),Irritable bowel syndrome(1%), gastro protection for concomitant drugs Aspirin(26%) and NSAIDs (22%).The patients who received more than one category drugs for GI related disorders are 175(58.3%). Prescriptions with PPIs and antacid given were 12%, Ranitidine (39%), both the drugs antacid and Ranitidine (7%).The differences in the socio-demographics of licensed and unlicensed indications patients were as shown in table 3. The comorbid conditions of the study population were as shown in figure 2. The prescriptions with licensed indications were 177(59.70%) and unlicensed indications 123(40.30%). Concomitant drugs along with PPI’s prescribed were high in most of the patients as shown in table 4. Average no. of drugs per prescription was 5.2. Figure 3 shows the diagnosis of the study population. Among the

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