Buy Guide
Twitter

Evaluating the use of subcutaneous proton pump inhibitors in the West Midlands via an online questionnaire

Background and Objectives

Palliative care patients frequently require treatment to suppress gastric acid secretions, for example in the management of malignant bowel obstruction, gastrointestinal bleeding (treatment and prophylaxis), dyspepsia and reflux symptoms. 1 This patient population  commonly experience swallowing difficulties 1, necessitating alternate routes to administer medications. Enteral tubes and intravenous cannula are uncomfortable and invasive, and consequently many medications are given subcutaneously.

Until recently the H2 receptor antagonist ranitidine has been used outside its license as a subcutaneous option for the indications above. Due to recent concerns over its safety profile however, ranitidine is not currently available.2 In addition to this, PPIs are more potent suppressors of gastric acid than H2 receptor antagonists 3, 4, and are the preferred choice for treating un-investigated dyspepsia. 5

Consequently, there is growing interest in the use of subcutaneous (SC) PPIs, a method of administration for these drugs where there is limited experience. This project aims to evaluate what, if any, experience palliative care healthcare professionals working in the West Midlands have of using SC PPIs.

Method

A literature review was conducted to look at current available experience in the use of SC PPIs. An online questionnaire was then emailed to healthcare professionals working in the field of palliative medicine in the West Midlands. The questions aimed to assess experience of using SC PPIs including drugs and doses used, efficacy, barriers to their use, and any adverse reactions.

Results

Awaited

Conclusion

References

1 Wilcock A, Howard P, Charlesworth S. Palliative Care Formulary. 8th ed. Pharmaceutical Press; 2023
2 Ranitidine (2021) NHS choices. NHS. Available at: https://www.nhs.uk/medicines/ranitidine /#:~:text =It%20has %20 been%20discontinued%20as,of%20acid%20your%20stomach% 20makes. (Accessed: February 27, 2023).
3 Zhang C, Kwong JS, Yuan RX, et al. Effectiveness and tolerability of different recommended doses of PPIs and H 2 RAs in GERD: network meta-analysis and GRADE system. Sci Rep. 2017;7(1):1-27
4 Strand DS, Kim D, Peura DA. 25 years of proton pump inhibitors: a comprehensive review. Gut Liv. 2017;11(1):27–37
5 Jones RH. Approaches to uninvestigated dyspepsia. Gut 2002;50(Suppl. IV):42–46

Details
Social Networks

You May Also Be Interested In

  • Palliative Care Guidance
  • Research Projects
  • Education & Events