Multimorbidities and Overprescription of Proton Pump Inhibitors in Older Patients.

Abstract

OBJECTIVES: To determine whether there is an association between overprescription of proton pump inhibitors (PPIs) and multimorbidities in older patients. DESIGN: Multicenter prospective study. SETTING: Acute geriatric medicine at the University Hospital of Nantes and the Hospital of Saint-Nazaire. PARTICIPANTS: Older patients aged 75 and over hospitalized in acute geriatric medicine. MEASUREMENTS: Older patients in acute geriatric medicine who received proton pump inhibitors. Variables studied were individual multimorbidities, the burden of multimorbidity evaluated by the Cumulative Illness Rating Scale, age, sex, type of residence (living in nursing home or not), functional abilities (Lawton and Katz scales), nutritional status (Body Mass Index), and the type of concomitant medications (antiaggregant, corticosteroids', or anticoagulants). RESULTS: Overprescription of proton pump inhibitors was found in 73.9% older patients. In the full model, cardiac diseases (odds ratio [OR] = 4.17, p = 0.010), metabolic diseases (OR = 2.14, p = 0.042) and corticosteroids (OR = 5.39, p = 0.028) were significantly associated with overprescription of proton pump inhibitors. Esogastric diseases (OR = 0.49, p = 0.033) were negatively associated with overprescription of proton pump inhibitors. CONCLUSION: Cardiac diseases and metabolic diseases were significantly associated with overprescription of proton pump inhibitors.