GI practitioners cease PPI use in patients due to concerns of side effects

Discontinuation of proton pump inhibitor (PPI) use remains prevalent, even within a group of mostly academic gastroenterology (GI) practitioners, despite evidence suggesting the safety of long-term PPI use without routine monitoring, a study has shown.

“Reports of side effects have prompted patients and practitioners alike to discontinue PPI use,” the researchers said. “Emerging evidence-based literature on PPI risks and safety seek to guide practitioners, but the impact of this literature on PPI prescribing patterns has not been evaluated.”

To address this, an anonymous online survey was conducted involving GI practitioners across six academic and community affiliated medical centres in the US. The researchers obtained demographic data including practice type and number of weekly gastroesophageal reflux disease patients seen.

Survey questions assessed the practitioners’ monitoring for PPI side effects, dose adjustments, and sources of information about PPI risks.

Of the 429 GI practitioners who received the survey, 256 (60 percent) responded. Majority of the respondents were male (n=169, 66 percent) attending physicians (n=178, 70 percent) practicing general GI (n=92, 25 percent). Ninety-two respondents (36 percent) reported testing for PPI side effects at least once a year.

More than half of the respondents (n=143, 56 percent) reported PPI discontinuation at least 50 percent of the time because of patients’ concerns about PPI side effects. Most of the respondents reported obtaining their information on PPI safety from published journals (n=239, 98 percent) and colleagues (n=222, 91 percent).

“Alternative strategies are needed to improve adherence to best practices, especially since gastroenterologists often serve as PPI experts,” the researchers said.