Proton pump inhibitors (PPIs) are one of the most widely used classes of drugs globally, often taken for longer than needed. Used to treat upper gastrointestinal disorders, long-term use of PPI medications can be potentially harmful and cause adverse side effects.

Despite international guidelines and Choosing Wisely recommendations, PPIs continue to be used beyond their recommended duration. Deprescribing can be an effective approach to tapper or stop medications that may no longer be necessary or cause harmful adverse events.

What are the barriers to change?

Clinicians may be reluctant to deprescribe PPIs due to concerns about the reappearance of heartburn or reflux symptoms, precipitating an upper gastrointestinal bleed, and symptom control. Deprescribing also takes time in planning and executing a dose reduction strategy.

How should practice change?

This BMJ practice pointer provides strategies and resources for identifying and deprescribing individuals on long-term PPIs. Authors highlight the importance of a shared decision-making approach to PPI deprescribing between clinicians and patients.