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Internists' Misconceptions About PPIs: Increasing Knowledge and Implementing Guidelines.

George F Longstreth1

  • 1Department of Gastroenterology, Kaiser Permanente Southern California, San Diego, CA, USA.

The American Journal of Gastroenterology
|February 15, 2020
PubMed
Summary
This summary is machine-generated.

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Physicians frequently misunderstand proton-pump inhibitor (PPI) side effects, leading to incorrect prescribing. Many internists wrongly stopped PPIs for high-risk patients, highlighting a need for better drug information dissemination.

Area of Science:

  • Internal Medicine
  • Pharmacology

Background:

  • Misconceptions regarding proton-pump inhibitor (PPI) adverse effects are prevalent among internists.
  • These misconceptions have led to alterations in prescribing practices.

Purpose of the Study:

  • To assess internists' understanding of PPI adverse effects in relation to upper gastrointestinal bleeding risk.
  • To identify factors influencing physician prescribing behavior and information seeking.

Main Methods:

  • Physicians were presented with four clinical scenarios involving upper gastrointestinal bleeding risk.
  • Prescribing decisions regarding PPI discontinuation were analyzed based on patient risk factors.

Main Results:

  • While 86% correctly discontinued PPIs for low-risk patients, 79% inappropriately discontinued them for high-risk patients (e.g., those with peptic ulcer history on aspirin).

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  • Physician self-assessment of knowledge was often inaccurate.
  • Time constraints and unanswered clinical questions, particularly concerning medications, were common barriers.

    • Conclusions:

    • Physician knowledge gaps regarding PPI adverse effects necessitate improved educational strategies.
    • Disseminating accurate, scientific drug information more rapidly and systematically monitoring guideline use are crucial for enhancing guideline implementation.