S3140 Does Age Influence How Gastroenterology Patients View Adverse Effects of Proton Pump Inhibitors?

Abstract

INTRODUCTION: Proton Pump Inhibitors (PPIs) are generally considered to be safe. Recently, observational studies have associated PPI use with new adverse drug reactions (ADRs) including chronic kidney disease, dementia, and hypomagnesemia. Few studies have addressed patient awareness of potential PPI-related ADRs and its effect on continued use of PPIs. In 2019, our group reported that most gastroenterology patients on PPIs were unaware of ADRs, but when alerted to potential ADRs, 60% expressed some degree of concern. We now report new findings on the influence of age on knowledge and concern about PPI-related ARDs and likelihood of discontinuing PPIs. METHODS: An anonymous survey with 15 multiple choice questions regarding PPI use was distributed to adults from our community outpatient endoscopy center at Advocate Lutheran General Hospital from June 2019 to January 2020. The survey included demographic information, indication and duration of PPI use, awareness of PPI ADRs, level of concern for ADRs, and drug discontinuation. RESULTS: 537 patients (14%) indicated current PPI use and are the subject of this analysis. 52 individuals were between the ages of 18-39 years (Group A = A), 276 were between the age of 40-65 years (Group B= B), and 209 individuals were > age 65 (Group C= C). The most common patient identified ADRs related to PPI use in all age groups were osteoporosis and Vitamin B12 deficiency (Figure 1). Most patients (55%) reported that they were unaware of any ADRs from PPIs. For patients aware of ADRs, the most common source of this information was from healthcare providers (A n = 10, B n = 60, C n = 42), and the Internet (A n = 9, B n = 41, C n = 16) (Figure 2). 377 patients (70%) expressed concern regarding ADRs. 21% expressed extreme concern (A n = 5, B n = 18, C n = 19), 23% moderate concern (A = 4, B = 24, C = 15), 41% were somewhat concerned (A n = 9, B n = 47, C n = 32), and 15% were hardly concerned (A n = 5, B n = 15, C n = 11). Patients over the age of 39 comprised 93% of patients (B n = 28, C n = 10) who discontinued PPIs due to concern about ADRs, compared to only 4 patients in A. CONCLUSION: The majority of patients on PPIs surveyed are unaware of PPI-related ADRs. Older patient populations are more likely to express concern for PPI-related ADRs and more likely to discontinue PPIs as a result.Figure 1.: The graph depicts the most common patient identified potential ADRs by age group.Figure 2.: The graph demonstrates where patients received their information regarding PPI ADRs by age group. Most patients surveyed regardless of age had learned of PPI ADRs from a physician.Figure 3.: The graph depicts the overall concern of patients by age related to PPI ADRs. The majority from all age groups are all somewhat concerned regarding PPI related ADRs.