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Successful deprescribing of proton pump inhibitors with a patient-centered process: the DESPIBP Project

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Background

Proton-pump inhibitors (PPIs) are among the most frequently prescribed drugs, but they are being overprescribed.

Objective

To evaluate the applicability of a deprescription algorithm in hospitalized patients with chronic PPI use.

Methods

A prospective study including consecutive gastroenterology department hospitalized patients with chronic PPI use. The prescription was reassessed and a deprescribing algorithm was applied. Follow-up was carried out at 4, 12, and 24 weeks.

Results

A total of 513 (44.22%) of 1160 had chronic PPI use; 371 met inclusion criteria and were evaluated: 285 (76.82%) with appropriate prescription and 86 (23.18%) with inappropriate, mainly (52.30%) due to polypharmacy. Seventy-five patients accepted the deprescribing process. Sixty-one (81.33%) maintained deprescription at week 4, 56 (74.66%) at week 12, and 54 (72.00%) at week 24. Eleven of 21 restarted the PPI because of symptoms. No differences were found between the successful deprescription group and the unsuccessful one, regarding sex (p = 0.877), age (p = 0.635), PPI indication (p = 0.663), or deprescription regimen (p = 0.805). No patient had any adverse event attributable to deprescription.

Conclusion

There is a high inappropriate indication for PPIs in patients admitted to the gastroenterology department. The application of a patient-centered deprescribing algorithm is a safe and effective strategy to reduce their inappropriate consumption in the medium term.

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Author information

Authors and Affiliations

  1. Gastroenterology Department, Miguel Servet University Hospital, Zaragoza, Spain

    Lamuela L. J. Calvo, P. García Cámara, M. Llorente Barrio, O. Sierra Gabarda, R. Monzón Baez, J. Alcedo González & V. Bernal Monterde

  2. Instituto de Investigación Sanitaria (IIS), Aragón, Zaragoza, Spain

    O. Sierra Gabarda, J. M. Arbonés Mainar, J. Alcedo González & V. Bernal Monterde

  3. Translational Research Unit, CIBER Physiopathology of Obesity and Nutrition, Miguel Servet University Hospital, Instituto Aragones de Ciencias de La Salud (IACS), Carlos III Health Institute, Zaragoza, Madrid, Spain

    J. M. Arbonés Mainar

Authors
  1. Lamuela L. J. Calvo
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  2. P. García Cámara
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  3. M. Llorente Barrio
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  4. O. Sierra Gabarda
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  5. R. Monzón Baez
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  6. J. M. Arbonés Mainar
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  7. J. Alcedo González
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  8. V. Bernal Monterde
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Contributions

Substantial contributions to the conception or design of the work: Bernal V, Alcedo J., Acquisition of data for the work: Lamuela LJ, García P, Llorente M, Sierra O, Monzón R., Analysis or interpretation of data for the work: Arbonés JM, Bernal V, Alcedo J., Drafting the work: Lamuela Calvo LJ and Bernal-Monterde V., Revising the work critically for important intellectual content: Arbonés JM, Bernal V, Alcedo J, García P.

Corresponding author

Correspondence to V. Bernal Monterde.

Ethics declarations

Ethics approval and consent to participate

This research complied with the guidelines for human studies and was conducted ethically in accordance with the World Medical Association Declaration of Helsinki. Subjects have given their written informed consent. This study was approved by our Institutional Review Board (Comité Ético de Investigación Clínica de Aragón, CEIC-A, reference number: EPA20/023, on April 29, 2020).

Conflict of interest

The authors declare no competing interests.

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Calvo, L.L.J., García Cámara, P., Llorente Barrio, M. et al. Successful deprescribing of proton pump inhibitors with a patient-centered process: the DESPIBP Project. Eur J Clin Pharmacol 77, 1927–1933 (2021). https://doi.org/10.1007/s00228-021-03186-x

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  • DOI: https://doi.org/10.1007/s00228-021-03186-x

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