Prescription and Usage of Proton Pump Inhibitors -A Cross-Sectional Study on Doctor's Knowledge, Attitude, and Practices in Kerala

Title: Knowledge, Attitude, and Practices of Doctors Regarding Proton Pump Inhibitor Prescription in Kerala: A Cross-Sectional Study Background: Proton pump inhibitors (PPIs) are widely prescribed for acid-related conditions like gastroesophageal reflux disease (GERD) and peptic ulcers. Despite their efficacy, inappropriate overuse and gaps in knowledge about long-term effects remain concerns. Objective: This study assesses the knowledge, attitudes, and practices (KAP) of doctors in Kerala, India, regarding PPI prescriptions. The goal is to identify commonly prescribed PPIs and explore the factors influencing prescribing behaviors. Methods: A cross-sectional survey was conducted among 100 healthcare professionals in Kerala using a structured questionnaire. The survey evaluated their knowledge of PPI indications, attitudes toward their use, and prescribing practices. KAP levels were categorized as low, moderate, or high based on responses. Results: The most commonly prescribed PPIs among respondents were Omeprazole, Pantoprazole, and Esomeprazole. The majority of doctors demonstrated high knowledge regarding the clinical benefits of PPIs for acute conditions like GERD. However, knowledge gaps were noted regarding the long-term risks, such as kidney damage and fractures. Attitude scores indicated general satisfaction with PPI therapy, but 35% of respondents expressed concerns about over-prescription, especially for mild or self-limiting conditions. Prescribing practices revealed a significant overuse of PPIs in patients with non-specific dyspepsia and those on chronic NSAID therapy. Conclusion: The study reveals significant gaps in knowledge about PPI risks and a tendency toward over-prescription. To optimize PPI usage, continued medical education and adherence to clinical guidelines are essential for improving prescribing practices and patient safety.