Analysis of proton pump inhibitor-associated drug problems and contributing factors among hospitalized nephrology patients

Aims To identify drug-related problems (DRPs) associated with proton pump inhibitors (PPIs) and their influencing factors among hospitalized nephrology patients, thereby providing evidence for the rational use of PPIs. Methods A retrospective cohort of internal nephrology inpatients who received PPIs between June 2024 and May 2025 was assembled. Clinical pharmacists applied the PCNE classification system (version 9.1) to identify and categorize PPI-related DRPs. Univariate and multivariate logistic regression analyses were performed to explore factors contributing to inappropriate PPIs use. Results A total of 520 patients were included, of which 241 patients (46.34%) experienced 303 DRPs. The most frequent problems involved drug selection and treatment duration. Multivariate analysis revealed that the following variables were independently associated with inappropriate PPIs use: purpose of PPI application (OR = 0.455, 95% CI 0.305–0.680, p < 0.001), antiplatelet agents (OR = 1.552, 95% CI 1.062–2.268, p = 0.023), anti-infective drugs (OR = 1.922, 95% CI 1.313–2.813, p = 0.001), and peritoneal dialysis (OR = 1.743, 95% CI 1.028–2.955, p = 0.039). Conclusion Systematic identification of PPI-related DRPs and analysis of their determinants by clinical pharmacists will substantially promote the rational use of PPIs in hospitalized patients with renal disease.