Prevalence and Associations of the Use of Proton-Pump Inhibitors in Nursing Homes: A Cross-Sectional Study

Objectives: Very scarce information is available about the use of proton-pump inhibitors (PPI) in nursing homes (NH). This study investigated the factors associated with PPI use among NH residents. Design: Cross-sectional Setting: One hundred seventy-five NHs in Midi-Pyrenees region, South-Western France. Participants: Data was collected for 6275 NH residents. Participants (73.7% women) were aged 86 years (+/- 8.2). Measurements: NH staff sent participants' drug prescriptions to research team; they also recorded information on residents' health characteristics. A binary logistic regression was performed on PPI use. Results: PPI use was highly prevalent (n = 2 370, ie, 37.8%). Whilst peptic ulcer (OR 4.741; 95% CI 3.647-6.163) and nonsteroidal anti-inflammatory drugs (OR 2.124; 95% CI 1.528-2.951) were important indicators of PPI use, they explained just a small fraction of PPI prescriptions; most prescriptions were probably inappropriately related to a general condition of health vulnerability, reflected by polypharmacy and comorbidities. Conclusions: Vulnerable people take PPIs more often in NHs. Physicians must be aware about the health risks possibly induced by inappropriate PPI use when prescribing these drugs for NH residents. Published by Elsevier Inc. on behalf of the American Medical Directors Association, Inc.