PPI deprescribing
Approached for comment, Adrienna Jirik, MD, a gastroenterologist at the Cleveland Clinic, told this news organization that “PPI overprescription is a common problem worldwide, with the United States being no exception.”
They are “one of the most prescribed medications in the world, with several formulations readily available as an over-the-counter medication,” she added.
Dr. Jirik, who was not involved with the study, said that the algorithm used is “on par with the United States clinical practice guidelines for PPI use” and a “great start to initiate an encounter with a patient on PPIs in the outpatient setting to review the indications and to de-escalate and deprescribe therapy.”
Indeed, the American Gastroenterological Association recently published a clinical practice update on deprescribing PPIs.
“It may be useful to incorporate a version of this algorithm as a ‘hard stop’ on some outpatient EMR [electronic medical record] templates to remind providers to address this issue prior to closing an encounter,” Dr. Jirik added.
She noted, however, that tackling any medication reconciliation is a very important but difficult and time-consuming task.
“Education is definitely key for both primary and subspecialty providers,” Dr. Jirik said. “If patients have been on a long-term PPI, the inpatient provider can suggest a plan for de-escalation based on practice guidelines and arrange proper outpatient follow-up for eventual deprescribing.”
No funding was declared. The authors and Dr. Jirik report no relevant financial relationships.
A version of this article first appeared on Medscape.com.