Abstract: Background and objectives: the aim of this study was to analyse the utilisation of proton
pump inhibitors (PPIs) during a 12-year period and to show the characteristics and patterns of their
prescribing. Materials and methods: firstly, in the pharmacoepidemiological analyses the ATC/DDD
methodology was used to assess the utilisation of PPIs in the Republic of Srpska. The annual PPI
utilisation was expressed as a number of DDD/1000 inhabitants/year. Secondly, the cross-sectional
surveys were used to reveal the characteristics of PPIs prescribing and medicines use, namely the
dose, duration and indication, and possible adverse reactions. For the purposes of the surveys,
the adapted version of questionnaires related to physicians’ and patients’ perspectives of medicines
prescribing and use were performed. Results: the utilisation of medicines for alimentary tract and
metabolism (group A/ATC classification) increased by almost threefold in a 12-year period, which
was consistent with the total medicine utilisation. Pantoprazole was the most prescribed medicine
among the PPIs. With the exclusion of PPIs in the therapy of Helicobacter pylori eradication, more
than half of family physicians prescribed PPIs with antibiotics, and only 53/239 physicians, noticed
some adverse reactions of PPIs in their patients. Most of the patients knew how to use PPIs and were
taking these medicines in recommended daily doses, but approximately 45% of them were using
PPIs for a long period of time (>6 months). Conclusions: the overuse of PPIs is a major concern due to
potential serious adverse reactions, especially in elderly patients and in a case of prolonged exposure.
