Proton pump inhibitors (PPIs) are often used inappropriately, without an indication, or for longer durations than recommended. At the Toronto Western Hospital Family Health Team, primary care providers of adults taking a PPI for 8 weeks with an upcoming periodic health examination were reminded to reassess therapy via electronic medical record (EMR) messaging. A PPI deprescribing tool was uploaded into the EMR as a second reminder and to guide reassessment and deprescribing where indicated. Using this strategy, 43 of 46 patients on PPIs (93%) had their PPI reassessed, resulting in 11 patients (26%) having their PPI deprescribed.
The Bye-Bye, PPI toolkit contains the key ingredients of their approach.