Retrospective cohort study links PPI use to drug-related problems in hospitalized renal disease patients.

This retrospective cohort study examined 520 hospitalized internal nephrology inpatients with renal disease to evaluate drug-related problems (DRPs) associated with proton pump inhibitors (PPIs). The primary outcome measured the proportion of patients experiencing DRPs, while secondary outcomes analyzed factors contributing to inappropriate PPI use. No specific adverse events or discontinuations were reported in the safety data.

A total of 303 DRPs were identified among the 520 patients. The proportion of patients experiencing DRPs was 46.34%, corresponding to 241 patients. Multivariate analysis revealed independent associations between the purpose of PPI application and inappropriate PPI use, with an odds ratio of 0.455 (95% CI 0.305–0.680, p < 0.001). This association was protective.

Conversely, concurrent use of antiplatelet agents was independently associated with inappropriate PPI use, with an odds ratio of 1.552 (95% CI 1.062–2.268, p = 0.023). Similarly, anti-infective drugs showed an independent association with inappropriate PPI use, with an odds ratio of 1.922 (95% CI 1.313–2.813, p = 0.001). Peritoneal dialysis was also independently associated with inappropriate PPI use, with an odds ratio of 1.743 (95% CI 1.028–2.955, p = 0.039). These associations were derived from multivariate analysis.

The study notes that systematic identification of PPI-related DRPs and analysis of their determinants by clinical pharmacists will substantially promote the rational use of PPIs in hospitalized patients with renal disease. The retrospective design limits causal inference regarding these associations.