Deprescription, Proton Pump Inhibitors
Conditions
Keywords
Proton pump inhibitors, Deprescription, Multi-faceted intervention, Patient-centered, Primary health care, Pharmacoepidemiology
Brief summary
Deprescribing is defined as the process of withdrawal of an inappropriate medication, supervised by a health care professional with the goal of managing the polypharmacy and improving outcomes. Inappropriate use of proton pump inhibitors (PPI) is associated with severe adverse drug reactions and a major economic impact. Deprescribing should be considered when inappropriate prescription of PPI is identified. DeprescrIPP DAM is a pragmatic trial, population-based, designed in clusters. It wil assess the efficacy of a multi-faceted intervention (an educational outreach visit to general practitioners associated with the sending of patient education material to their patients) to deprescribe PPI.
Interventions
OTHERGP will receive the educational outreach visit by a DAM (healthcare representative).
GP will receive the educational outreach visit by a DAM (healthcare representative).
OTHERPatient education material on PPI deprescribing will be sent to the patients
Patient education material on PPI deprescribing will be sent to the patients
Sponsors
Nantes University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* General practitioners (GP) • All GP settled in the French region Pays-de-la-Loire having seen more than 100 different patients in the year before baseline, will be eligible. * Patients * Aged more than 18 years old * Affiliated to the French health insurance CPAM * Treated with PPI\> 300DDD/year in the year before baseline (estimated with reimbursement databases). * Whose GP is included in the study
Exclusion criteria
* General practitioners (GPs) : • Participation refusal * Patients * Participation refusal * Patients at risk of gastroduodenal lesions i.e. treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and over 65 years old or treated with either corticosteroids or anticoagulants or platelet aggregation inhibitors * Patients under legal protection
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| PPI deprescribing | 12 months | Proportion of patients achieving a 50% decrease in their reimbursement of PPI (Defined Daily Dose (DDD)/year) at the end of the intervention compared to baseline (estimated with reimbursement databases) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Characteristics of patients engaging in the deprescription process | 12 months | Sex, age, long-term illness, universal health insurance, complementary health insurance, medication |
Countries
France
Outcome results
None listed