ĐÁNH GIÁ TÍNH HỢP LÝ VÀ TƯƠNG TÁC THUỐC TRONG SỬ DỤNG THUỐC ỨC CHẾ BƠM PROTON TẠI KHOA TIM MẠCH CAN THIỆP-THẦN KINH BỆNH VIỆN TRƯỜNG ĐẠI HỌC Y DƯỢC CẦN THƠ

Abstract

Background: Inappropriate proton pump inhibitor (PPI) prescription increases the risk of adverse drug reactions (ADRs) and healthcare costs. Among clinically relevant interactions, the concomitant use of PPIs and clopidogrel is critical as it potentially attenuates antiplatelet efficacy and elevates cardiovascular risks. Objectives: To evaluate patient characteristics, determine the prevalence of drug–drug interactions (DDIs), and assess the appropriateness of PPI prescribing in the Departments of Interventional Cardiology and Neurology at Can Tho University of Medicine and Pharmacy Hospital. Materials and methods: A cross-sectional descriptive study was conducted on 400 inpatient medical records of patients receiving PPI therapy from December 2024 to December 2025. Results: The mean patient age was 68.1 ± 12.7 years, with 55.5% presenting with multimorbidity. Gastroesophageal reflux disease (GERD) was the primary indication for PPI therapy (95.8%), and rabeprazole was the most frequently prescribed agent (93.5%). The overall DDI prevalence was 68.5%, of which 8.4% were classified as severe, predominantly driven by the CYP2C19-mediated esomeprazole–clopidogrel interaction. Appropriate prescribing rates were 94.3% for indication, 100% for dosage/administration route, and 95.3% for PPI selection. Notably, inappropriate esomeprazole use leading to clinically significant DDIs was identified in 4.7% of charts. Conclusions: While PPI dosing and administration strictly adhered to guidelines, the risk of clinically significant DDIs remains a major concern. Rabeprazole or pantoprazole should be prioritized in patients requiring concurrent dual antiplatelet therapy (DAPT). Enhancing the clinical pharmacist's role in automated DDI screening is vital to optimize patient safety.