Proton Pump Inhibitors: Rational Use and Use-Reduction - The Windsor Workshop.
Dig Dis
; 42(3): 211-220, 2024.
Article
em En
| MEDLINE
| ID: mdl-38513623
ABSTRACT
BACKGROUND:
Despite deprescribing initiatives to curb overutilization of proton pump inhibitors (PPIs), achieving meaningful reductions in PPI use is proving a challenge.SUMMARY:
An international group of primary care doctors and gastroenterologists examined the literature surrounding PPI use and use-reduction to clarify (i) what constitutes rational PPI prescribing; (ii) when and in whom PPI use-reduction should be attempted; and (iii) what strategies to use when attempting PPI use-reduction. KEY MESSAGES Before starting a PPI for reflux-like symptoms, patients should be educated on potential causes and alternative approaches including dietary and lifestyle modification, weight loss, and relaxation strategies. When commencing a PPI, patients should understand the reason for treatment, planned duration, and review date. PPI use at hospital discharge should not be continued without a recognized indication for long-term treatment. Long-term PPI therapy should be reviewed at least annually. PPI use-reduction should be based on the lack of a rational indication for long-term PPI use, not concern for PPI-associated adverse events. PPI use-reduction strategies involving switching to on-demand PPI or dose tapering, with rescue therapy for rebound symptoms, are more likely to succeed than abrupt cessation.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Inibidores da Bomba de Prótons
Limite:
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article