Assessing Geriatric Proton Pump Inhibitor Prescribing and Polypharmacy in General Practice with an Educational Intervention by Physiology Students

Michael Pollock, Ben Roddy, Derek A Scott

Research output: Contribution to conferencePoster

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Abstract

Polypharmacy is a rising concern in the Scottish elderly population. Proton Pump Inhibitors (PPIs) are among the most widely sold and distributed drugs in the world and are overprescribed in primary health care settings. The older population are at a greater risk of side-effects when taking PPIs due to changes in their physiology during the ageing process. As part of the approach to widen the range of Honours projects undertaken by Honours Physiology students, we initiated a partnership with a GP practice to help them assess whether they were prescribing PPIs appropriately to their older population and to improve their understanding of deprescribing of PPI’s. We aimed to assess polypharmacy and PPI prescribing in the >75 year old population of Oakley Health Centre, in Fife, Scotland. This project also aimed to observe the efficacy of an intervention in reducing polypharmacy and promoting PPI deprescribing and to evaluate the attitudes of clinicians towards the use of PPIs and polypharmacy. A two cycle audit and an educational intervention were carried out between the 17th of January and the 7th of March 2019. The first audit undertaken was pre-intervention, and the second post-intervention, to assess effectiveness of intervention. An oral presentation, demonstration videos and an infographic algorithm were created for the educational intervention, presented to staff on the 6th February 2019. Two surveys were distributed, one assessing attitudes of staff towards deprescribing and polypharmacy, and one collecting opinions of the intervention and educational resources. Results: The first audit found 32.6% of patients >75 years old were on a repeat PPI prescription, and the second audit found 32.7% (Not significant at p<0.05). The number of these patients on >5 additional medications was 89.8% in first audit, and 89.7% in second audit (Not significant at p<0.05). 60% of clinicians said PPIs were overprescribed, and 100% considered polypharmacy to be an issue within the local area. 83% agreed the intervention highlighted issues regarding PPI prescribing and made them more likely to deprescribe in appropriate patients. Respondents also reported that they had had very little formal education on deprescribing, and that they felt there was a lack of resources to help them in this regard. Conclusion: Despite no significant change seen acutely post intervention in this short, time-limited project, the resources created were well received. A further re-audit has been scheduled for a date six months after initiation of this project to investigate longer-term effects of this intervention. Results demonstrate the scale of local PPI overprescribing and polypharmacy, and a longer-term audit/ intervention has the potential to improve these issues more significantly. This project also demonstrates how physiology students may usefully contribute to quality improvement work with healthcare professionals.
Original languageEnglish
Publication statusPublished - 2019
EventPhysiology 2019 - Aberdeen Exhibition & Conference Centre, Aberdeen, United Kingdom
Duration: 8 Jul 201910 Jul 2019
http://www.physoc.org/physiology2019/physiology-2019

Conference

ConferencePhysiology 2019
CountryUnited Kingdom
CityAberdeen
Period8/07/1910/07/19
Internet address

Fingerprint

Polypharmacy
Proton Pump Inhibitors
General Practice
Geriatrics
Students
Population
Attitude of Health Personnel
Scotland
Quality Improvement
Prescriptions
Primary Health Care

Keywords

  • proton pump inhibitors
  • Quality improvement
  • physiology
  • polypharmacy

Cite this

Assessing Geriatric Proton Pump Inhibitor Prescribing and Polypharmacy in General Practice with an Educational Intervention by Physiology Students. / Pollock, Michael; Roddy, Ben; Scott, Derek A.

2019. Poster session presented at Physiology 2019, Aberdeen, United Kingdom.

Research output: Contribution to conferencePoster

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N2 - Polypharmacy is a rising concern in the Scottish elderly population. Proton Pump Inhibitors (PPIs) are among the most widely sold and distributed drugs in the world and are overprescribed in primary health care settings. The older population are at a greater risk of side-effects when taking PPIs due to changes in their physiology during the ageing process. As part of the approach to widen the range of Honours projects undertaken by Honours Physiology students, we initiated a partnership with a GP practice to help them assess whether they were prescribing PPIs appropriately to their older population and to improve their understanding of deprescribing of PPI’s. We aimed to assess polypharmacy and PPI prescribing in the >75 year old population of Oakley Health Centre, in Fife, Scotland. This project also aimed to observe the efficacy of an intervention in reducing polypharmacy and promoting PPI deprescribing and to evaluate the attitudes of clinicians towards the use of PPIs and polypharmacy. A two cycle audit and an educational intervention were carried out between the 17th of January and the 7th of March 2019. The first audit undertaken was pre-intervention, and the second post-intervention, to assess effectiveness of intervention. An oral presentation, demonstration videos and an infographic algorithm were created for the educational intervention, presented to staff on the 6th February 2019. Two surveys were distributed, one assessing attitudes of staff towards deprescribing and polypharmacy, and one collecting opinions of the intervention and educational resources. Results: The first audit found 32.6% of patients >75 years old were on a repeat PPI prescription, and the second audit found 32.7% (Not significant at p<0.05). The number of these patients on >5 additional medications was 89.8% in first audit, and 89.7% in second audit (Not significant at p<0.05). 60% of clinicians said PPIs were overprescribed, and 100% considered polypharmacy to be an issue within the local area. 83% agreed the intervention highlighted issues regarding PPI prescribing and made them more likely to deprescribe in appropriate patients. Respondents also reported that they had had very little formal education on deprescribing, and that they felt there was a lack of resources to help them in this regard. Conclusion: Despite no significant change seen acutely post intervention in this short, time-limited project, the resources created were well received. A further re-audit has been scheduled for a date six months after initiation of this project to investigate longer-term effects of this intervention. Results demonstrate the scale of local PPI overprescribing and polypharmacy, and a longer-term audit/ intervention has the potential to improve these issues more significantly. This project also demonstrates how physiology students may usefully contribute to quality improvement work with healthcare professionals.

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KW - proton pump inhibitors

KW - Quality improvement

KW - physiology

KW - polypharmacy

M3 - Poster

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