Proton Pump Inhibitors and the Prescribing Cascade
Authors: Rababa Mohammad , Al-Ghassani Amal Ali , Kovach Christine R. , Dyer Elaine M. 
Published: December 2015

How to Obtain Contact Hours by Reading This Article

Instructions

1.3
contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at
http://goo.gl/gMfXaf
. To obtain contact hours you must:

1.
Read the article, “Proton Pump Inhibitors and the Prescribing Cascade” found on pages 23–31, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz.

2.
Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study.

3.
Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated.

This activity is valid for continuing education credit until March 31, 2019.

Contact Hours
This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated.
Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

Activity Objectives

1.
Describe the prescribing cascade of proton pump inhibitors (PPI) in nursing home residents.

2.

Identify the statistically significant factors related to the use of PPI and H
2
receptor blockers.

Disclosure Statement
Neither the planners nor the authors have any conflicts of interest to disclose.

The current study examined the use of proton pump inhibitor (PPI) drugs in 248 nursing home residents and factors associated with being prescribed a PPI. Ninety-three percent of residents taking a PPI had done so for longer than recommended durations. As anticholinergic burden, vitamin/supplement use, and number of oral products taken daily increased, residents were more likely to be taking a PPI. Higher anticholinergic burden (
p
= 0.031) and number of oral products taken daily (
p
= 0.04) were two statistically significant predictors in the final logistic regression model. Significant predictors of PPI use in the current study may be explained by the association between polypharmacy and dyspepsia and the lowering of esophageal sphincter pressure by anticholinergic drugs. High use of PPIs in nursing home residents may represent a prescribing cascade. [
Journal of Gerontological Nursing
,
42
(4), 23–31.]