Abstract
BackgroundProton 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.Methodsthis 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.Resultsthe 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.Conclusionsconcerns 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.
Highlights
Proton pump inhibitors (PPIs) are effective in treating gastroesophageal reflux, peptic ulcers, and esophagitis
The current study reported that a low percentage of the participants had previously attempted to stop PPI use due to its adverse effect profile, with the majority of these attempts having been made without the consultation of a primary care provider (PCP)
The current study found that participants were more likely to attempt to discontinue a PPI if they were advised to do so by a PCP, if they discussed the adverse effects of PPI use with a PCP, and if they had increased concerns regarding the long-term adverse effects of PPI use
Summary
Proton pump inhibitors (PPIs) are effective in treating gastroesophageal reflux, peptic ulcers, and esophagitis. 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. The inappropriate prescribing of medications for older adults is a prevalent issue [1]. A recent study found the prevalence of the inappropriate prescribing of medications for older adults in community health centers to reach 40% [2]. Proton-pump inhibitors (PPIs) are the drug of choice for managing gastroesophageal reflux disease (GERD). PPIs are highly effective in treating chronic peptic ulcers and nonerosive and erosive esophagitis via long-term acid suppression, which could otherwise lead to serious consequences (e.g., scarring and cancer) [5]. Up to 70% of the PPI prescriptions for older adults in the US and the United Kingdom (UK) in 2014 were without a clinically reasonable indication [9]
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