Approaches to Deprescribing Proton Pump Inhibitors in Clinical Practice: A Systematic Review
Journal of Clinical Medicine,
Journal Year:
2024,
Volume and Issue:
13(20), P. 6283 - 6283
Published: Oct. 21, 2024
Background:
Proton
pump
inhibitors
(PPIs)
are
some
of
the
most
frequently
prescribed
medications,
but
they
often
used
inappropriately,
either
being
without
a
clear
indication
or
continued
for
longer
than
necessary.
In
such
cases,
deprescribing
is
recommended.
However,
despite
its
proven
effectiveness,
implementation
in
clinical
practice
remains
inconsistent
and
varied,
making
it
challenging
to
identify
effective
strategies.
The
goal
provide
comprehensive
outline
interventions
PPI
therapy
implemented
across
various
settings
by
different
healthcare
professionals.
Methods:
study
designed
be
systematic
review
published
literature.
PubMed,
Embase,
Web
Science
databases
were
searched
from
1
January
1989
(the
first
on
market)
30
September
2024
articles
assessing
adult
patients,
focusing
rate
(primary
outcome)
effects
symptoms
(secondary
outcome).
Results:
After
screening,
66
studies
included,
predominantly
pragmatic
trials
(N
=
32)
randomized
controlled
25).
We
found
variety
promoting
deprescription.
Collaborative
efforts
involving
multiple
professionals,
use
algorithms
decision-making,
patient
involvement
have
key
elements
Discontinuing
may
not
advisable
cases
recurrent
symptoms,
suggesting
that
on-demand
could
recommended
approach.
Deprescribing
particularly
relevant
individuals
with
mild
illnesses
where
tapering
can
effectively
mitigate
rebound
associated
abrupt
discontinuation.
Conclusions:
Given
current
prevalence
inappropriate
prescribing,
imperative
raise
awareness
among
both
physicians
patients
about
importance
process,
which
should
tailored
specific
needs
each
patient,
considering
his/her
medical
history,
health
status,
personal
preferences.
Language: Английский
Educational Brochures for Deprescribing
JAMA Internal Medicine,
Journal Year:
2024,
Volume and Issue:
184(11), P. 1289 - 1289
Published: Sept. 23, 2024
Language: Английский
RELEASE: REdressing Long-tErm Antidepressant uSE in adults in general practice (RELEASE): A two-arm parallel-group cluster RCT effectiveness-implementation hybrid type-1 study
medRxiv (Cold Spring Harbor Laboratory),
Journal Year:
2024,
Volume and Issue:
unknown
Published: Oct. 10, 2024
Abstract
The
REdressing
Long-tErm
Antidepressant
uSE
in
general
practice
(RELEASE)
trial
is
a
pragmatic
cluster
randomized
controlled
(cRCT)
that
seeks
to
determine
whether
novel
multi-strategy
intervention
supports
safe
cessation
of
long-term
antidepressants
superior
Usual
Care.
1
Pragmatic
trials
are
designed
how
well
interventions
work
clinical
under
everyday
conditions.
2
has
two
forms,
known
as
RELEASE
and
RELEASE+.
for
patients
includes
direct
patient
education
resources
3
an
invitation
medication
review;
practitioners
(GPs)
education,
training
the
brief
(Ask,
Advise,
Assist)
printable
via
management
software.
RELEASE+
additionally
links
freely
available
information
online
App,
GPs
audit
feedback
on
prescribing
antidepressants.
Patient
directed
material
potential
support
safer
prescribing,
including
this
case
improved
recognition
antidepressant
withdrawal
symptoms.
4,
5
Brief
have
change
GP
behaviour.
6
primary
comparison
interest
any
A
secondary
will
be
between
types
(RELEASE
RELEASE+).
purpose
document
minimise
bias
ensure
transparency
internal
validity
findings
trial,
by
defining
making
publicly
analysis
approach
prior
reviewing
or
analysing
data.
statistical
plan
(SAP)
inform
reporting
main
effectiveness
trial.
It
provides
detailed
description
outcomes
methods
comparison.
Language: Английский