Proton pump inhibitor prescribing patterns in the UK: a primary care database study

Area of Science:

• Pharmacology
• General Practice
• Health Services Research

Background:

• Proton pump inhibitors (PPIs) are widely prescribed for acid-related disorders.
• Concerns exist regarding long-term PPI use and potential adverse effects.
• Strategies to de-prescribe PPIs are increasingly important in primary care.

Purpose of the Study:

• To determine the prevalence and patterns of PPI prescription in the UK general population.
• To investigate the practices used to reduce PPI use.
• To identify opportunities for optimizing PPI prescribing.

Main Methods:

• Utilized the UK's Clinical Practice Research Database (CPRD) from 1990-2014.
• Estimated annual point and period prevalence of PPI use.
• Conducted a cohort analysis of new PPI users to assess cessation and duration patterns.

Main Results:

• PPI prevalence rose significantly: period prevalence from 0.2% to 15.0% and point prevalence from 0.03% to 7.7% (1990-2014).
• In a cohort of 596,334 new users, 26.7% used PPIs long-term (≥1 year), and 3.9% used them for 5 years.
• Attempts to reduce PPI dosage were documented in 39.9% of long-term users and 47% of those with non-mandated long-term use.

Conclusions:

• Observed a substantial increase in PPI prescribing within UK general practice.
• A significant proportion (60%) of long-term PPI users did not have attempts to discontinue or reduce dosage.
• Improving adherence to PPI withdrawal strategies presents opportunities to reduce costs and side effects.