S3149 Does Gender Play a Role in How Gastroenterology Patients View Adverse Effects of Proton Pump Inhibitors?

Abstract

INTRODUCTION: Proton Pump Inhibitors (PPIs) are generally considered to be safe. Recent observational studies have associated PPI use with potential adverse drug reactions (ADRs) including chronic kidney disease, dementia, and vitamin deficiencies. Patient awareness of potential ADRs and its effect on continued use of PPIs have received little attention in the medical literature. Our group previously reported initial data showing that the majority of gastroenterology patients taking PPIs are unaware of associated ADRs, but when alerted to ADRs, 60% expressed some degree of concern. We now report new findings on the effect of gender on knowledge and concern about PPI-related ADRs, and likelihood of discontinuing PPIs. METHODS: An anonymous survey with 15 multiple choice questions regarding PPI use (2 questions allowing more than 1 answer) was distributed to adults from our single community outpatient endoscopy center at Advocate Lutheran General Hospital from June 2019 to January 2020. It included demographic information, indication and duration of PPI use, awareness of PPI ADRs, level of concern for ADRs, and drug discontinuation. RESULTS: 3775 surveys were returned, of which 537 patients (14%) [male (M) n = 248 (46%), female (F) n = 289 (54%)], were current PPI users and are the subject of this analysis. The most common indications for PPI usage were heartburn (M n = 137, F n = 161) and GERD (M n = 124, F n = 149). Females were more aware of individual PPI-associated ARDs than males (Figure 1). The most common patient-identified ADRs related to PPI use by women was osteoporosis (F n = 53, M n = 18) and in men was vitamin B12 deficiency (M n = 25, F n = 37)Figure 1.: The graph depicts the most common patient identified potential ADRs by gender group. The most frequently identified potential ADRs by women are osteoporosis, low calcium absorption, and B12 deficiency. The most frequently identified potential ADRs by men are Vitamin B12 deficiency, kidney disease, and low iron absorption.Figure 2.: The graph depicts the overall concern of patients by gender related to PPI ADRs. Although women were more concerned than men, the majority are all somewhat concerned regarding PPI related ADRs.Figure 3.: The graph depicts the reason patients, by gender, discontinued their PPI. More women discontinued their PPI due to concern regarding ADRs rather than men.. Of 377 patients (70%) who expressed concern regarding ADRs, 21% expressed extreme concern (F = 58%), 23% moderate concern (F = 69%), 41% were somewhat concerned (F = 51%), and 15% were hardly concerned (F = 61%) (Figure 2). Of 168 patients (32%, M n = 66, F n = 102) who attempted to stop their PPI, 41 patients (24%, M n = 15, F n = 26) reported stopping secondary to ADRs concern (Figure 3). CONCLUSION: The majority of GI patients consuming PPIs are unaware of PPI-related ADRs. Our study data suggests that females are more aware of ADRs and are attentive a variety of ADRs. Females express a greater degree of concern regarding PPI use, and are more likely to discontinue their PPI therapy compared to males.