Abstract
BackgroundNot much is known about patient perceptions regarding proton pump inhibitor (PPI) de-escalation. We sought to determine the knowledge of adverse effects (AEs) and willingness to de-escalate therapy among patients presenting to primary care and subspecialty clinics.MethodsWe conducted an anonymous survey of patients presenting to family medicine, internal medicine, and gastroenterology clinics who use PPIs. Survey topics included awareness of and concern for AEs of PPIs, and willingness to de-escalate PPI therapy.ResultsThe sample comprised 206 participants presenting to the gastroenterology (29.8%), internal medicine (32.2%), and family medicine clinics (38%). Of the participants, 16% were “extremely concerned” about AEs and 28.2% reported attempting to stop PPIs by themselves in the past. Many patients (54.9%) reported that providers had not discussed AEs before initiation. Patients visiting digestive disease clinics were no more likely to report discussions on AEs and de-escalation or discontinuation attempts compared to primary care patients (p-values > 0.05). On logistic regression analysis, concern for AEs and counseling regarding PPI discontinuation were found to be significantly associated with attempts to discontinue PPI.ConclusionsAlthough many patients on PPIs are concerned about AEs, a low number of patients reported provider-initiated discussions on AEs of PPI at initiation.
Highlights
Proton pump inhibitors (PPIs) have been documented extensively in the literature to be among the most commonly prescribed drug classes in the United States [1]
Patients visiting digestive disease clinics were no more likely to report discussions on adverse effects (AEs) and de-escalation or discontinuation attempts compared to primary care patients (p-values > 0.05)
Concern for AEs and counseling regarding PPI discontinuation were found to be significantly associated with attempts to discontinue PPI
Summary
Proton pump inhibitors (PPIs) have been documented extensively in the literature to be among the most commonly prescribed drug classes in the United States [1]. Despite the attention that PPIs and their adverse effects have garnered in the literature currently, little is known about how such adverse effects are perceived by patients presenting to different subspecialties and primary care. We sought to determine the difference in knowledge of such adverse effects and willingness to de-escalate or discontinue PPI therapy between patients presenting to primary care and those presenting to subspecialty gastroenterology clinics. Not much is known about patient perceptions regarding proton pump inhibitor (PPI) de-escalation. We sought to determine the knowledge of adverse effects (AEs) and willingness to de-escalate therapy among patients presenting to primary care and subspecialty clinics
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