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Irrational PPI Use and Its Economic Impact: An Observational Study on Prescribing Practices in Dehradun
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| Author:
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DR. SHIKHA DWIVEDI, DR. LIBIN SANJEEV L, DR. RAKSHANDA DOOMRA, DR. SANJAY GAUR
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| Abstract:
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Introduction: Proton pump inhibitors (PPIs) are frequentlyprescribed for acid-related gastrointestinal disorders, but often irrationally, without clear indications. This study aimed to assess the burden, appropriateness, and economic implications of PPIs and WHO core prescribing indicators were utilized to evaluate overall prescription practices in a tertiary care hospital in Dehradun.
Methods: This cross-sectional observational study was conducted over three months (Jan–Mar 2025) in the outpatient departments of Government Doon Medical College. A total of 622 prescriptions were analysed for PPI content, indication, cost and WHO core prescribing indicators and results published via descriptive parameters. IEC approved (GDMC/IEC/2023/85)
Results: Out of 622 prescriptions, 424 (68.17%) contained at least one PPI. Of these, 124 (29.25%) lacked appropriate indications. Pantoprazole was most commonly prescribed, often in fixed-dose combinations. Total prescription cost was ?3,04,118, with ?76,984 (25.31%) spent on PPIs. Unjustified PPI use accounted for ?23,558 (31% of PPI cost). WHO indicators showed high polypharmacy (avg. 4.14 drugs/encounter), low generic prescribing (35.69%), and underutilization of essential medicines (59.81%).
Discussion: Nearly one-third of PPI use was irrational, significantly adding to patient costs. Prescribing patterns also deviated from WHO standards, highlighting polypharmacy and brand preference. Limitations include the observational design and outpatient-only data.
Conclusion: There is a pressing need to promote rational PPI use and improve overall prescribing practices through prescriber education and institutional audits.
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| Keyword:
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Proton Pump Inhibitors, Pantoprazole, Prescriptions, Polypharmacy, Outpatients, Tertiary Care Centers, World Health Organization
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2025.17.03.007
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| Download:
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