Study protocol: Health outcomes analysis of a strategy for deprescribing proton pump inhibitors.

e202502011

Authors

  • Amaya Echeverría Gorriti Subdirección de Farmacia y Prestaciones; Servicio Navarro de Salud-Osasunbidea. Pamplona. España. / Instituto de Investigación Sanitaria de Navarra (IdiSNA). Pamplona. España. https://orcid.org/0000-0001-9225-5323
  • Andrea Rodríguez Esquíroz Subdirección de Farmacia y Prestaciones; Servicio Navarro de Salud-Osasunbidea. Pamplona. España. / Instituto de Investigación Sanitaria de Navarra (IdiSNA). Pamplona. España. https://orcid.org/0009-0006-8635-6084
  • Patricia García González Subdirección de Farmacia y Prestaciones; Servicio Navarro de Salud-Osasunbidea. Pamplona. España. / Instituto de Investigación Sanitaria de Navarra (IdiSNA). Pamplona. España. https://orcid.org/0000-0002-5029-9368
  • Lorea Sanz Álvarez Subdirección de Farmacia y Prestaciones; Servicio Navarro de Salud-Osasunbidea. Pamplona. España. / Instituto de Investigación Sanitaria de Navarra (IdiSNA). Pamplona. España. https://orcid.org/0000-0003-0571-5438
  • Marta Marín Marín Subdirección de Farmacia y Prestaciones; Servicio Navarro de Salud-Osasunbidea. Pamplona. España. / Instituto de Investigación Sanitaria de Navarra (IdiSNA). Pamplona. España. https://orcid.org/0000-0002-0609-6467
  • Javier Gorricho Mendívil Subdirección de Farmacia y Prestaciones; Servicio Navarro de Salud-Osasunbidea. Pamplona. España. https://orcid.org/0000-0003-3609-9922
  • Julen Fernández González Instituto de Investigación Sanitaria de Navarra (IdiSNA). Pamplona. España. / Osakidetza-Servicio Vasco de Salud. Servicio de Farmacia; Hospital de Zumárraga. Zumárraga. España. https://orcid.org/0000-0003-4435-2780
  • Mª Concepción Celaya Lecea Subdirección de Farmacia y Prestaciones; Servicio Navarro de Salud-Osasunbidea. Pamplona. España. https://orcid.org/0000-0001-7700-7911
  • Ana Campillo Arregui Servicio Navarro de Salud-Osasunbidea; Gerencia del Área de Salud de Tudela. Hospital Reina Sofía. Tudela. España.
  • Rebeca Irisarri Garde Servicio Navarro de Salud-Osasunbidea. Servicio de Digestivo; Hospital Universitario de Navarra. Pamplona. España.
  • Javier Garjón Parra Subdirección de Farmacia y Prestaciones; Servicio Navarro de Salud-Osasunbidea. Pamplona. España. / Instituto de Investigación Sanitaria de Navarra (IdiSNA). Pamplona. España. https://orcid.org/0000-0002-0126-7431

Keywords:

deprescribing, proton pump inhibitors, gastropathy

Abstract

Background:

Proton pump inhibitors (PPI) are one of the groups of drugs with the highest prevalence of use. However, in many cases they are used for the treatment of unapproved indications. For this reason, in Navarra a strategy was implemented to deprescribe PPI in those cases in which their use was not indicated.

Subsequently, a project was designed in order to analyze the health outcomes of that PPI deprescription strategy.

 

Methods:

A retrospective cohort study will be developed to evaluate health outcomes obtained after the implementation of the PPI deprescription strategy. The primary outcome will be the time until a serious adverse event, defined as one that causes hospital admission or death.  We will analyze whether there are differences between patients who stopped PPI treatment and those who maintained it.

 

 

Discussion:

It is expected to obtain information on the health outcomes of the proton pump inhibitor deprescription strategy and information about the convenience of continuing it.

 

 

 

 

Downloads

Download data is not yet available.

References

Shanika LGT, Reynolds A, Pattison S, Braund R. Proton pump inhibitor use: systematic review of global trends and practices. Eur J Clin Pharmacol. 2023;79(9):1159-1172. doi: https://dx.doi.org/10.1007/s00228-023-03534-z

Agencia Española de Medicamentos y Productos Sanitarios. [Consultado el 10 de septiembre de 2024]. https://cima.aemps.es/cima/publico/home.html

Nguyen PV-Q, Boidin C, Bouin M. Effectiveness of prescribing codes in reducing inappropriate proton pump inhibitors in ambulatory care. J Am Pharm Assoc (2003). 2023;63(4):1197-1202. doi: https://dx.doi.org/10.1016/j.japh.2023.05.006

Vidonscky Lüthold R, Henz NC, Fuhrer C et al. Inappropriate proton-pump inhibitor prescribing in primary care-an observational study with quality circles. Swiss Med Wkly. 2023;153:40119. doi: https://dx.doi.org/10.57187/smw.2023.40119

Çelik F, Aypak C, Özdemir A, Görpelioglu S. Inappropriate Prescribing of Proton Pump Inhibitors in Outpatient Clinics. Gastroenterol Nurs Off J Soc Gastroenterol Nurses Assoc. 2021;44(2):84-91. doi: https://dx.doi.org/10.1097/SGA.0000000000000500

Boster J, Lowry LE, Bezzant ML, Kuiper B, Surry L. Reducing the Inappropriate Use of Proton Pump Inhibitors in an Internal Medicine Residency Clinic. Cureus. 2020;12(1):e6609. doi: https://dx.doi.org/10.7759/cureus.6609

UpToDate. Proton pump inhibitors: Overview of use and adverse effects in the treatment of acid related disorders. [Consultado el 10 de septiembre de 2024] https://www.uptodate.com/contents/proton-pump-inhibitors-overview-of-use-and-adverse-effects-in-the-treatment-of-acid-related-disorders

Chinzon D, Domingues G, Tosetto N, Perrotti M. Safety of long-term proton pump inhibitors: facts and myths. Arq Gastroenterol. 2022;59(2):219-225. doi: https://dx.doi.org/10.1590/S0004-2803.202202000-40

Ali MD. Proton Pump Inhibitors’ Use and Risk of Iron Deficiency Anaemia: A Systematic Review and Meta-analysis. Curr Rev Clin Exp Pharmacol. 2023;18(2):158-166. doi: https://dx.doi.org/10.2174/2772432817666220307121220

Boxer M. Iron deficiency anemia from iron malabsorption caused by proton pump inhibitors. EJHaem. 2020;1(2):548-551. doi: https://dx.doi.org/10.1002/jha2.96

Gommers LMM, Hoenderop JGJ, De Baaij JHF. Mechanisms of proton pump inhibitor-induced hypomagnesemia. Acta Physiol (Oxf). 2022;235(4):e13846. doi: https://dx.doi.org/10.1111/apha.13846

Anna Vermeulen Windsant-van den Tweel AM, Derijks HJ, Gadiot NPPM, Keijsers CJPW. Proton Pump Inhibitors and Hypomagnesemia in Older Inpatients: An Observational Study. Sr care Pharm. 2022;37(12):623-630. doi: https://dx.doi.org/10.4140/TCP.n.2022.623

Xun X, Yin Q, Fu Y, He X, Dong Z. Proton Pump Inhibitors and the Risk of Community-Acquired Pneumonia: An Updated Meta-analysis. Ann Pharmacother. 2022;56(5):524-532. doi: https://dx.doi.org/10.1177/10600280211039240

Tawam D, Baladi M, Jungsuwadee P, Earl G, Han J. The Positive Association between Proton Pump Inhibitors and Clostridium Difficile Infection. Inov Pharm. 2021;12(1). doi: https://dx.doi.org/10.24926/iip.v12i1.3439

Inghammar M, Svanström H, Voldstedlund M, Melbye M, Hviid A, Mølbak K et al. Proton-Pump Inhibitor Use and the Risk of Community-Associated Clostridium difficile Infection. Clin Infect Dis an Off Publ Infect Dis Soc Am. 2021;72(12):e1084-e1089. doi: https://dx.doi.org/10.1093/cid/ciaa1857

Seo SI, You SC, Park CH, Kim TJ, Ko YS, Kim Y et al. Comparative risk of Clostridium difficile infection between proton pump inhibitors and histamine-2 receptor antagonists: A 15-year hospital cohort study using a common data model. J Gastroenterol Hepatol. 2020;35(8):1325-1330. doi: https://dx.doi.org/10.1111/jgh.14983

AEMPS. Utilización de Medicamentos Antiulcerosos En España. 2024. [Consultado el 10 de septiembre de 2024] https://www.aemps.gob.es/medicamentos-de-uso-humano/observatorio-de-uso-de-medicamentos/informes/#

American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi: https://dx.doi.org/10.1111/jgs.18372

O’Mahony D, Cherubini A, Guiteras AR, Denkinger M, Beuscart JB, Onder G et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med. 2023;14(4):625-632. doi: https://dx.doi.org/10.1007/s41999-023-00777-y

Lavan AH, Gallagher P, Parsons C, O’Mahony D. STOPPFrail (Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy): Consensus validation. Age Ageing. 2017;46(4):600-607. doi: https://dx.doi.org/10.1093/ageing/afx005

Alzueta Isturiz, N, Echeverria Gorriti A, Celaya Lecea MC, Fontela Bulnes MC, Sanz Álvarez L, Acin Gerico MT. Deprescripción de inhibidores de la bomba de protones en pacientes que no cumplen indicación de tratamiento. BMJ evidence-based Med. 2018;Suppl 2:A58-A59. doi: https://dx.doi.org/10.1136/bmjebm-2018-111070.124

Alzueta Isturiz, N, Echeverria Gorriti A, Celaya Lecea MC, Fontela Bulnes MC, Sanz Álvarez L AGM. Estrategia de optimización del tratamiento con inhibidores de la bomba de protones. Publicado en línea en 2018.

Boghossian TA, Rashid FJ, Thompson W, Welch V, Moayyedi P, Rojas-Fernandez C et al. Deprescribing versus continuation of chronic proton pump inhibitor use in adults. Cochrane Database Syst Rev. 2017;2017(3). doi: https://dx.doi.org/10.1002/14651858.CD011969.pub2

Calvini G, Baiardi G, Mattioli F, Milano G, Calautti F, Zunino A et al. Deprescribing Strategies: A Prospective Study on Proton Pump Inhibitors. J Clin Med. 2023;12(8). doi: https://dx.doi.org/10.3390/jcm12083029

Lamuela Calvo LJ, García Cámara P, Llorente Barrio M, Sierra Gabarda O, Monzón Baez R, Arbonés Mainar JM et al. Successful deprescribing of proton pump inhibitors with a patient-centered process: the DESPIBP Project. Eur J Clin Pharmacol. 2021;77(12):1927-1933. doi: https://dx.doi.org/10.1007/s00228-021-03186-x

Visser AGR, Schols JMGA, Prevoo MALM, Janknegt R, Winkens B. Deprescribing Statins and Proton Pump Inhibitors in Nursing Home Residents; a Pragmatic Exploratory Study. Gerontol Geriatr Med. 2021;7:23337214211050810. doi: https://dx.doi.org/10.1177/23337214211050807

Magin P, Quain D, Tapley A, van Driel M, Davey A, Holliday E et al. Deprescribing in older patients by early-career general practitioners: Prevalence and associations. Int J Clin Pract. 2021;75(8):e14325. doi: https://dx.doi.org/10.1111/ijcp.14325

Odenthal DR, Philbrick AM, Harris IM. Successful deprescribing of unnecessary proton pump inhibitors in a primary care clinic. J Am Pharm Assoc. 2020;60(1):100-104. doi: https://dx.doi.org/10.1016/j.japh.2019.08.012

Published

2025-02-26 — Updated on 2025-02-26

Versions

How to Cite

1.
Echeverría Gorriti A, Rodríguez Esquíroz A, García González P, Sanz Álvarez L, Marín Marín M, Gorricho Mendívil J, et al. Study protocol: Health outcomes analysis of a strategy for deprescribing proton pump inhibitors.: e202502011. Rev Esp Salud Pública [Internet]. 2025 Feb. 26 [cited 2025 May 31];99(1):9 páginas. Available from: https://ojs.sanidad.gob.es/index.php/resp/article/view/955

Most read articles by the same author(s)