Language
English
Publication Date
1-1-2024
Journal
Digestive Diseases
DOI
10.1159/000538399
PMID
38513623
PMCID
PMC11152023
PubMedCentral® Posted Date
3-21-2024
PubMedCentral® Full Text Version
Post-Print
Abstract
BACKGROUND: Despite deprescribing initiatives to curb overutilization of proton pump inhibitors (PPIs), achieving meaningful reductions in PPI use is proving a challenge.
SUMMARY: An international group of primary care doctors and gastroenterologists examined the literature surrounding PPI use and use-reduction to clarify: (i) what constitutes rational PPI prescribing; (ii) when and in whom PPI use-reduction should be attempted; and (iii) what strategies to use when attempting PPI use-reduction.
KEY MESSAGES: Before starting a PPI for reflux-like symptoms, patients should be educated on potential causes and alternative approaches including dietary and lifestyle modification, weight loss, and relaxation strategies. When commencing a PPI, patients should understand the reason for treatment, planned duration, and review date. PPI use at hospital discharge should not be continued without a recognized indication for long-term treatment. Long-term PPI therapy should be reviewed at least annually. PPI use-reduction should be based on the lack of a rational indication for long-term PPI use, not concern for PPI-associated adverse events. PPI use-reduction strategies involving switching to on-demand PPI or dose tapering, with rescue therapy for rebound symptoms, are more likely to succeed than abrupt cessation.
Keywords
Proton pump inhibitors, Gastroesophageal reflux disease, Oesophagus
Published Open-Access
yes
Recommended Citation
Kahrilas, Peter; Anastasiou, Foteini; Bredenoord, Albert J; et al., "Proton Pump Inhibitors: Rational Use and Use-Reduction - The Windsor Workshop" (2024). Faculty and Staff Publications. 1379.
https://digitalcommons.library.tmc.edu/baylor_docs/1379