• William Hood, Brittain McJunkin, Alicia Warnock, Aditi Girme, Nelson Smith, and Brandon Robinson.
• W V Med J. 2014 Jan 1;110(1):16-21.

UnlabelledConcerns have been raised regarding potential adverse effects and high costs of proton pump inhibitors (PPIs). Our objective was to assess issues of PPI utilization and expense in a large outpatient clinic population.MethodsTwo hundred-fifty-nine outpatient records were reviewed regarding PPI prescribing and indications during 2009. A cost analysis was performed to project cost differences if histamine-2 receptor antagonists (H2RAs) were used as an alternative to PPIs in appropriate clinical situations.ResultsEighty-three (32.0%) were taking PPIs. Problem-listed gastroesophageal reflux disease (GERD) was the primary diagnosis in 69 (83.1%) of patients on PPIs. GERD was not apparent by documented history and/or endoscopy in 46.3% of problem-listed GERD patients. Symptom severity had been documented in only 36.2%. Cost analysis projected substantial savings if H2RAs had been used initially for mild to moderate symptoms.ConclusionsOutpatient PPI prescribing indications are not well documented and PPI use is probably excessive. H2RA therapy is likely underutilized.

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