PMID- 38062116
OWN - NLM
STAT- MEDLINE
DCOM- 20231216
LR  - 20231222
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 13
IP  - 1
DP  - 2023 Dec 7
TI  - Efficacy of a computer based discontinuation strategy to reduce PPI 
      prescriptions: a multicenter cluster-randomized controlled trial.
PG  - 21633
LID - 10.1038/s41598-023-48839-2 [doi]
LID - 21633
AB  - Deprescribing of inappropriate long-term proton pump inhibitors (PPI) is 
      challenging and there is a lack of useful methods for general practitioners to 
      tackle this. The objective of this randomized controlled trial was to evaluate 
      the effectiveness of the electronic decision aid tool arriba-PPI on reduction of 
      long-term PPI intake. Participants (64.5 +/- 12.9 years; 54.4% women) with a PPI 
      intake of at least 6 months were randomized to receive either consultation with 
      arriba-PPI from their general practitioner (n = 1256) or treatment as usual 
      (n = 1131). PPI prescriptions were monitored 6 months before, 6 and 12 months 
      after study initiation. In 49.2% of the consultations with arriba-PPI, the 
      general practitioners and their patients made the decision to reduce or 
      discontinue PPI intake. At 6 months, there was a significant reduction by 22.3% 
      (95% CI 18.55 to 25.98; p < 0.0001) of defined daily doses (DDD) of PPI. A 
      reduction of 3.3% (95% CI - 7.18 to + 0.62) was observed in the control group. At 
      12 months, the reduction of DDD-PPI remained stable in intervention patients 
      (+ 3.5%, 95% CI - 0.99 to + 8.03), whereas control patients showed a reduction of 
      DDD-PPI (- 10.2%, 95% CI - 6.01 to - 14.33). Consultation with arriba-PPI led to 
      reduced prescription rates of PPI in primary care practices. Arriba-PPI can be a 
      helpful tool for general practitioners to start a conversation with their 
      patients about risks of long-term PPI intake, reduction or deprescribing 
      unnecessary PPI medication.
CI  - (c) 2023. The Author(s).
FAU - Heisig, Julia
AU  - Heisig J
AD  - Department of Primary Care, University of Marburg, Marburg, Germany. 
      julia.heisig@uni-marburg.de.
FAU - Bucker, Bettina
AU  - Bucker B
AD  - Institute of General Practice (Ifam), Centre for Health and Society (Chs), 
      Medical Faculty, Heinrich Heine University Dusseldorf, Dusseldorf, Germany.
FAU - Schmidt, Alexandra
AU  - Schmidt A
AD  - Chair of General Practice II and Patient-Centeredness in Primary Care, Institute 
      of General Practice and Primary Care (IGPPC), Faculty of Health, Witten/Herdecke 
      University, Witten, Germany.
FAU - Heye, Anne-Lisa
AU  - Heye AL
AD  - Chair of General Practice I and Interprofessional Care, Institute of General 
      Practice and Primary Care (IGPPC), Faculty of Health, Witten/Herdecke University, 
      Witten, Germany.
FAU - Rieckert, Anja
AU  - Rieckert A
AD  - Chair of General Practice II and Patient-Centeredness in Primary Care, Institute 
      of General Practice and Primary Care (IGPPC), Faculty of Health, Witten/Herdecke 
      University, Witten, Germany.
FAU - Loscher, Susanne
AU  - Loscher S
AD  - Institute of General Practice (Ifam), Centre for Health and Society (Chs), 
      Medical Faculty, Heinrich Heine University Dusseldorf, Dusseldorf, Germany.
FAU - Hirsch, Oliver
AU  - Hirsch O
AD  - Department of Psychology, FOM University of Applied Sciences, Siegen, Germany.
FAU - Donner-Banzhoff, Norbert
AU  - Donner-Banzhoff N
AD  - Department of Primary Care, University of Marburg, Marburg, Germany.
FAU - Wilm, Stefan
AU  - Wilm S
AD  - Institute of General Practice (Ifam), Centre for Health and Society (Chs), 
      Medical Faculty, Heinrich Heine University Dusseldorf, Dusseldorf, Germany.
FAU - Barzel, Anne
AU  - Barzel A
AD  - Department of General Practice and Primary Care, Ulm University Hospital, Ulm, 
      Germany.
FAU - Becker, Annette
AU  - Becker A
AD  - Department of Primary Care, University of Marburg, Marburg, Germany.
FAU - Viniol, Annika
AU  - Viniol A
AD  - Department of Primary Care, University of Marburg, Marburg, Germany.
LA  - eng
GR  - 01VSF17025/Gemeinsame Bundesausschuss/
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20231207
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Humans
MH  - Female
MH  - Male
MH  - *Proton Pump Inhibitors/therapeutic use
MH  - Communication
MH  - *General Practitioners
MH  - Practice Patterns, Physicians'
MH  - Cognition
PMC - PMC10703926
COIS- The authors declare no competing interests.
EDAT- 2023/12/08 00:42
MHDA- 2023/12/17 13:19
PMCR- 2023/12/07
CRDT- 2023/12/07 23:31
PHST- 2023/04/12 00:00 [received]
PHST- 2023/11/30 00:00 [accepted]
PHST- 2023/12/17 13:19 [medline]
PHST- 2023/12/08 00:42 [pubmed]
PHST- 2023/12/07 23:31 [entrez]
PHST- 2023/12/07 00:00 [pmc-release]
AID - 10.1038/s41598-023-48839-2 [pii]
AID - 48839 [pii]
AID - 10.1038/s41598-023-48839-2 [doi]
PST - epublish
SO  - Sci Rep. 2023 Dec 7;13(1):21633. doi: 10.1038/s41598-023-48839-2.