Deprescibing Proton Pump Inhibitors

February 23, 2021

Gastroenterology (Digestive Health)

In 2018/19, 494,683 Albertans (or 11% of the population) were prescribed proton pump inhibitors (PPIs) to manage heartburn and other acid-related disorders. Of those, 28% were prescribed at a dose higher than the recommended standard. Estimates suggest that up to 40% of patients in Alberta are over-prescribed PPIs, which increases an avoidable medication burden, as well as system and patient costs. This over-prescribing includes extending treatment beyond eight weeks and dosing twice per day instead of once, both in the absence of a clear indication for the PPI. 

Dr. Sander Veldhuyzen Van Zanten, in partnership with the AHS Digestive Health SCN and the PLP, presented the webinar Bye-Bye PPI: Towards optimal prescribing of PPIs to a pharmacist stakeholder group in September and at the Clinical Connections Conference in October 2020. He presented a third webinar, Prescribing and deprescribing PPI in the elderly, in March 2021. In February, the PLP hosted the webinar Deprescribing PPI in Alberta, attended by 37 physicians and team members. It described the extent of PPI use in Alberta, identified appropriate situations for prescribing and deprescribing PPIs, presented tools (developed with the PLP) that can support patient discussions and decision making about PPI prescribing, and provided physicians with the opportunity to reflect on their own PPI prescribing practices. Electronic copies of all the physician and patient tools for deprescribing PPIs were distributed to all 237 registrants for these events.

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