Rationalizing Proton Pump Inhibitor Use: Southeast Asia Consensus Recommendations

Area of Science:

• Gastroenterology
• Pharmacology

Background:

• Proton pump inhibitors (PPIs) are widely used for gastrointestinal conditions.
• Inappropriate prescription of PPIs is a significant concern in Southeast Asia (SEA).
• Lack of region-specific guidelines necessitates tailored recommendations for PPI use.

Purpose of the Study:

• To develop recommendations for rationalizing PPI prescribing in SEA.
• To address the issue of inappropriate long-term PPI use and its potential adverse effects.
• To guide healthcare providers in SEA on appropriate PPI initiation, review, and deprescribing.

Main Methods:

• A working group of 14 experts from six SEA countries was formed.
• Evidence review and a modified Delphi method with anonymous voting were employed.
• Twenty consensus statements were developed covering PPI overprescription, rationalization benefits/barriers, criteria, and strategies.

Main Results:

• Widespread inappropriate long-term PPI prescription in SEA was confirmed, posing risks.
• While PPI rationalization offers benefits, implementation challenges exist.
• Specific indications for PPI initiation, regular review for deprescribing, and strategies like shared decision-making and rescue therapy were outlined.

Conclusions:

• The consensus document aims to enhance PPI prescribing and deprescribing practices in SEA.
• Recommendations focus on rationalization strategies to optimize PPI use.
• Improved PPI management is expected to benefit patients across the region.