GP perspectives on a computer-assisted strategy to support PPI deprescribing: a qualitative study

Area of Science:

• Primary Care Medicine
• Health Informatics
• Pharmacology

Background:

• Proton pump inhibitors (PPIs) are frequently prescribed but often overused in primary care.
• Prolonged PPI use increases patient risk of adverse events.
• Digital decision-support tools aim to improve medication management and deprescribing.

Purpose of the Study:

• To explore general practitioners' (GPs) experiences with the arriba-PPI digital tool.
• To identify factors influencing the tool's use and impact on PPI prescribing.
• To understand barriers and facilitators for PPI deprescribing in primary care.

Main Methods:

• Qualitative exploratory study using semi-structured interviews with 26 GPs.
• Embedded within a multicentre cluster-randomised controlled trial in German general practices.
• Thematic analysis of interview data using a deductive-inductive approach.

Main Results:

• GPs found the arriba-PPI tool useful for structured communication and shared decision-making, especially with hesitant patients.
• The tool enhanced GPs' awareness of their prescribing habits.
• Barriers included technical issues, workflow integration, and lack of non-drug alternatives; trust and relationships were key.

Conclusions:

• The arriba-PPI tool supports PPI deprescribing conversations but requires optimization and integration.
• Successful deprescribing depends on technical improvements, workflow fit, and non-pharmacological strategies.
• Future digital interventions should adopt a holistic, patient-centered approach for sustained impact.