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Quality Improvement Report Open Access
Aims was undertaken to ensure concomitant usage of
proton pump inhibitors (PPIs) with Non-Steroidal Antiinflammatory
Drugs (NSAIDs) in Elderly, in order to avoid
upper gastrointestinal (GI) symptoms and ulcers.
Methods: Reviewing of 386 patients' prescription on
the EMIS (Egton Medical Information Systems) Web, on
April 2014. Checking who have not been prescribed PPIs
with NSAIDs, offering them appointment for prescription
and discussion about risks and benefits of PPIs. Re-audit of
390 patients' prescription on the EMIS Web, on July 2014.
Exclusion criteria in the audit and re-audit were; NSAIDs
usage for more than 3 years, contra-indications for PPIs, and
patients who declined inclusion in the audit.
Results: In the first audit cycle, a total of 386 patients'
prescription reviewed, 23 (6%) patients were not prescribed
PPIs with NSAIDs and were eligible for PPIs prescription.
Those patients were contacted by post, an appointment arranged
for them and prescribed the PPIs. 12 weeks later a re-audit
was done, showed that all patients (100%) who are prescribed
NSAIDs are prescribed prophylactic PPIs. None of the patients
who are prescribed NSAIDs and PPIs concomitantly developed
upper GI symptoms or ulcers.
Conclusions: The audit increased the awareness of the
junior doctors of the importance of concomitant prescription of
PPIs with NSAIDs, in accordance with the electronic Medical
Compendium (eMC) guidelines, to prevent upper GI symptoms
and ulcers. That was reflected in the re-audit having 100% of
the patients prescribed NSAIDs and PPIs concomitantly.
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Author(s): Babikir Kheiri
non-steroidal anti-inflammatory drugs, proton pump inhibitors, Innovative primary care, Primary care medicines, Advanced concepts in primary care