Patient and Provider Perspectives on Deprescribing Proton Pump Inhibitors

Area of Science:

• Geriatric Medicine
• Pharmacology
• Health Services Research

Background:

• Proton pump inhibitors (PPIs) are widely prescribed for acid-related disorders.
• Long-term PPI use in older adults is common but may be associated with inappropriate prescribing and potential adverse effects.
• Deprescribing PPIs in geriatric populations presents unique challenges.

Purpose of the Study:

• To describe proton pump inhibitor (PPI) prescribing patterns in patients aged 65 and older.
• To explore provider and patient perspectives on PPI deprescribing.
• To identify barriers to discontinuing PPI therapy in the geriatric population.

Main Methods:

• Retrospective chart review of 107 patients aged ≥65 on PPI therapy.
• Prospective cross-sectional survey analysis of 19 patients and 74 healthcare providers.
• Assessment of PPI appropriateness based on dose, duration, and indication.

Main Results:

• Proton pump inhibitor (PPI) therapy was potentially inappropriate for 66% of older adult patients reviewed.
• Identified provider barriers to deprescribing included fear of outcomes, documentation access, and guideline uncertainty.
• Significant prevalence of long-term PPI use without clear clinical indications was observed.

Conclusions:

• Long-term PPI use is prevalent in geriatric patients, frequently without appropriate indications.
• Healthcare provider concerns and guideline ambiguity represent significant barriers to PPI deprescribing.
• Addressing these barriers is crucial for safe and effective PPI deprescribing in older adults to mitigate associated risks.