Alkem

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DUE PPI

A multicenter, retrospective, cross-sectional real-world evidence study to assess the utilization and prescribing patterns of proton pump inhibitors (PPIs) in India.

Subject Initials *

Investigator *

Centre *

ASSESSMENT OF THERAPY PRESCRIBED

Date of Assessment *

DEMOGRAPHICS and ANTHROPOMETRY

Age (in Years) *

Gender *

Male Female

Weight (kg) *

Place *

Occupation *

MEDICAL AND SURGICAL HISTORY

Was patient in OPD/IPD? *

Patient prescribed with PPIs *

Pregnancy induced hypertension Gestational diabetes mellitus

CURRENT MEDICAL ILLNESS

Presenting Complains/symptoms *

Diagnosis*

TREATMENT OF CURRENT MEDICAL ILLNESS

Generic/brand Name	Dose	Frequency	Route	Duration

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