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Proton Pump Inhibitor Use in Older Adults: Long-Term Risks and Steps for Deprescribing.

Sara Pezeshkian1, Susan E Conway2

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This summary is machine-generated.

Proton pump inhibitors (PPIs) can cause adverse effects with long-term use. Deprescribing PPIs and considering alternatives like lifestyle changes or histamine-2-receptor antagonists is recommended for patient safety.

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Area of Science:

  • Gastroenterology
  • Pharmacology
  • Geriatrics

Background:

  • Proton pump inhibitors (PPIs) are widely prescribed for acid-related gastrointestinal disorders.
  • Approved PPI therapy duration is typically 2 to 12 weeks.
  • Many patients continue PPIs beyond recommended durations without clear indications.

Purpose of the Study:

  • To review the risks associated with long-term proton pump inhibitor use.
  • To discuss strategies for PPI deprescribing and patient management.
  • To highlight alternative therapies and lifestyle modifications.

Main Methods:

  • Literature review of studies on PPIs, adverse events, and deprescribing.
  • Analysis of risks including acute interstitial nephritis, fractures, and Clostridium difficile-associated diarrhea (CDAD).
  • Evaluation of alternative treatments and lifestyle interventions.

Main Results:

  • Long-term PPI use is linked to significant adverse drug events.
  • Older adults may face higher risks of PPI-related adverse effects.
  • Deprescribing, alternative medications (e.g., H2RAs), and lifestyle changes can mitigate risks.

Conclusions:

  • Cautious PPI prescribing and regular patient monitoring are essential.
  • Deprescribing should be considered for many long-term PPI users.
  • Patient education on risks and alternatives is critical for safe management.