The incidence of postoperative and persistent usage of proton pump inhibitors following surgery

Abstract

INTRODUCTION: The use of proton pump inhibitors (PPI) has increased over the past decades. Some patients use the medication without an indication. It is possible that new use will start following surgery. The study aimed to examine the incidence of postoperative use of PPI following surgeries and the ratio of new persistent users over three months postoperatively as well as patient- and procedural variables associated with new use and new persistent use. METHODS: Data of surgeries among adults that had undergone surgeries at the National University Hospital of Iceland from 2006 to 2018. The data were from the Icelandic perioperative database, containing information regarding medication usage preceding and following surgeries. The ratio of those who started using PPI within three months of surgery was assessed, and the ratio of persistent users. RESULTS: Altogether, 2886 out of 42.530 patients filled PPI prescription within three months after their first surgery. Annual incidence was 67 per 1.000 surgeries, and the ratio of persistent users was 54%, although both the varied between years. The use was more common among women, highest in age group 56-65 years old, patients with polypharmacy (5-9 medicines) and who underwent abdominal surgeries. CONCLUSIONS: New postoperative PPI use is common following surgery and half of the patients with new use develop new persistent use. The usage increased similar to the increased number of prescriptions and sales of PPI in other patient groups during the period. The results indicate the need for further monitoring of patients with PPI prescriptions following surgeries in Iceland.