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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1468750

Improving the feasibility of deprescribing proton pump inhibitors: GPs' insights on barriers, facilitators, and strategies

Provisionally accepted
Nuša Japelj Nuša Japelj 1Lea Knez Lea Knez 1,2Davorina Petek Davorina Petek 3Nejc Horvat Nejc Horvat 1*
  • 1 Department of Social Pharmacy, Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
  • 2 University Clinic of Pulmonary and Allergic Diseases Golnik, Golnik, Slovenia
  • 3 Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

The final, formatted version of the article will be published soon.

    The prevalent overprescribing of proton pump inhibitors (PPIs) poses health risks from prolonged use. GPs play a key role in initiating deprescribing PPIs, so understanding their decision-making factors and strategies to improve feasibility is crucial. This study aimed to investigate the perspectives of GPs on deprescribing PPIs with a focus on identifying facilitators, barriers, and strategies to enhance feasibility in clinical settings.Methods: A qualitative study involving semi-structured interviews was conducted with nine GPs or trainees. The thematic analysis of the interviews was conducted using NVivo R1 (2020).Results: Four main categories were identified: 1) Inappropriate prescribing of PPIs, 2) Facilitators for deprescribing PPIs, 3) Barriers to deprescribing PPIs, 4) Feasibility of deprescribing PPIs. GPs acknowledged excessive and often inappropriate PPI prescribing, with a lack of deprescribing efforts mainly due to time constraints. Other key barriers included patient reluctance, fear of symptom recurrence, and unawareness of long-term risks. Patient-initiated request is key facilitator for deprescribing PPIs. GPs emphasized the need for collaboration with healthcare professionals, clear guidelines, improved digital support, increased physician availability, and raising awareness among providers and patients to enhance deprescribing feasibility.Discussion: GPs are calling for a multifaceted approach to improve the feasibility of deprescribing PPIs, involving patient-centered approaches, systemic optimizations, support from other healthcare professionals, and provider-centered strategies to emphasize the importance of deprescribing PPIs.

    Keywords: deprescriptions1, primary health care2, proton pump inhibitors3, inappropriate prescribing4, Qualitative research5

    Received: 22 Jul 2024; Accepted: 06 Sep 2024.

    Copyright: © 2024 Japelj, Knez, Petek and Horvat. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Nejc Horvat, Department of Social Pharmacy, Faculty of Pharmacy, University of Ljubljana, Ljubljana, 1000, Slovenia

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.