Proton pump inhibitors (PPIs) are widely used for a number of gastric-acid related diseases. Although these agents demonstrate enhanced efficacy and tolerability compared with other acid-suppressive therapies, long-term use is associated with a number of adverse reactions. This article summarizes appropriate indications for short- and long-term use of PPIs and describes deprescribing strategies that clinicians can use to reduce unnecessary PPI use in their patients.
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http://dx.doi.org/10.1097/01.JAA.0000000000000130 | DOI Listing |
Public Health Nurs
December 2024
Clinical Pharmacy and Pharmacoepidemiology Research Group, Louvain Drug Research Institut, Université Catholique de Louvain, Woluwé, Belgium.
Background: Deprescribing is a strategy to optimize medication use and to prevent medication harm. Despite the fact that behavioral theories have been shown to be useful in explaining health behaviors, the literature on deprescribing relies almost exclusively on attitudes as an explanatory factor for deprescribing behavior. This study systematically reviews the literature that made explicit use of the constructs included in health behavior theories (HBTs) to explain older adults' and informal caregivers' deprescribing behavior and outcomes.
View Article and Find Full Text PDFBr J Clin Pharmacol
December 2024
Department of Renal Medicine, University College London, London, UK.
Structured medication reviews (SMRs) were introduced into the National Health Service (NHS) Primary Care to support the delivery of the NHS Long-Term Plan for medicines optimization. SMRs improve the quality of care, reduce harm and offer value for money. However, evidence to support SMRs for patients with chronic kidney disease (CKD) stage G4-5D with elevated risk of cardiovascular disease and premature mortality is unknown.
View Article and Find Full Text PDFImplement Sci Commun
December 2024
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
Background: Prescribing cascades, which occur when a medication is used to treat the side effect of another medication, are important contributors to polypharmacy. There is an absence of studies that evaluate interventions to address them. We describe an application of the Behaviour Change Wheel (BCW) to design theory-informed interventions for addressing prescribing cascades within interprofessional primary care teams.
View Article and Find Full Text PDFEClinicalMedicine
December 2024
Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, NSW, Australia.
Background: International low back pain guidelines recommend providing education/advice to patients, discouraging routine imaging use, and encouraging judicious prescribing of analgesics. However, practice variation occurs and the effectiveness of implementation strategies to promote guideline-concordant care is unclear. This review aims to comprehensively evaluate the effectiveness of implementation strategies to promote guideline-concordant care for low back pain.
View Article and Find Full Text PDFPharmacy (Basel)
October 2024
Pharmacy Service, Centre Hospitalo-Universitaire Amiens-Picardie, F-80000 Amiens, France.
Purpose: Anticholinergic drugs can cause adverse events (AEs) in older adults. Clinical decision support systems (CDSSs) can detect prescriptions with a high anticholinergic load. Our starting hypothesis was that the anticholinergic load could be reduced by combining a CDSS with a strategy for generating pharmacist interventions.
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