Community-dwelling older adults’ awareness of the inappropriate use of proton pump inhibitors

Abstract

Background Proton pump inhibitors (PPIs) are effective in treating gastroesophageal reflux, peptic ulcers, and esophagitis. However, the long-term use of PPIs by older adults is associated with adverse health outcomes. There is limited evidence about older adults’ awareness of long-term PPI use and its associated adverse effects. This study aimed to assess older adults’ awareness of the adverse effects of the long-term use of PPIs, and their willingness to stop PPI use given of the risks and benefits of PPI use. Methods this cross-sectional study was conducted on a convenience sample of 120 older adults from three local healthcare centers located in Irbid, Jordan. Older adults’ awareness of PPI use was measured using the Patients’ Perceptions of Proton Pump Inhibitor Risks and Attempts at Discontinuation Survey. Results the majority of the participating older adults were not familiar with any reports linking long-term PPI use with adverse effects, reported no concerns related to the chronic use of PPIs, and reported that they had not discussed the benefits and risks of PPI use with their primary care providers (PCPs). Although the majority of the participants had not previously attempted to stop using PPIs, the majority expressed a willingness to stop PPIs due to their adverse effects, especially if advised to do so by a PCP. The factors associated with the long-term use of PPIs included age, indications for gastrointestinal reflux disease (GERD), improvement of GERD symptoms, and the willingness to reduce or stop PPIs. Being advised by a PCP to stop PPIs (p = 0.049) and having increased concerns about the adverse effects of long-term PPI use (p < 0.0001) were the only two statistically significant predictors of previous attempts to stop PPIs. Conclusions concerns regarding the adverse effects of long-term PPI use were associated with attempts to stop PPIs, especially in cases where this was recommended by a PCP. Discussions between PCPs and patients regarding the risks and benefits of PPIs are necessary in order to ensure that patients do not make inappropriate decisions regarding ongoing PPI therapy. Careful evaluation of the long-term use of PPIs among older adults is required.

Potentially inappropriate medications use and its associated factors among geriatric patients: a cross-sectional study based on 2019 Beers Criteria

“…However, their use for more than 8 weeks should be avoided because they are associated with Clostridium difficile infection and bone loss and fracture (Fick et al 2019). Patient education and increasing healthcare knowledge about long-term side effects of PPIs is necessary especially that studies show a lack of awareness of inappropriate use PPIs and their related adverse events among patients (Rababa and Rababa'h 2020) and healthcare providers including physicians, pharmacists and nurses (Luo et al 2019;Asdaq et al 2021).…”

Potentially Inappropriate Medications in Hospitalized Older Patients in Tabuk, Saudi Arabia Using 2023 Beers Criteria: A Retrospective Multi-Centric Study

“…Older adults generally expect the prescribers to prescribe them with PPIs and PPIs dramatically improve their quality of life. 35 The proportion of medications to be used with caution was 19.55%, and diuretics were the most frequently prescribed medications. Similar to our study results, another study reported that the prevalence of PIMs that should be avoided was 60.7%, with gastrointestinal drugs commonly prescribed, and the prevalence of PIMs that should be used with caution was 40.6%, with diuretics, antidepressants and antiplatelet drugs commonly prescribed.…”

Potentially Inappropriate Prescribing among Elderly Outpatients: Evaluation of Temporal Trends 2012–2018 in Piedmont, Italy

“…However, physicians’ and patients’ awareness regarding this issue remains poor. In a survey on 120 elderly patients, the majority of the participants were not familiar with any reports linking long-term proton pump inhibitor use with adverse effects, reported no concerns related to their chronic use, and stated that they had not discussed the benefits and risks of this therapy with their primary care providers [ 40 , 41 ]. It is also to be acknowledged that older adults often report feeling uncomfortable discussing whether to stop proton pump inhibitors with their providers [ 42 ].…”