Who has the guts to deprescribe proton pump inhibitors? A pharmacist‐led intervention in a long‐term care facility setting

Objective Long‐term use of proton pump inhibitors ( PPI s) has been associated with an increased risk of harm. There are few studies evaluating pharmacist‐led PPI deprescribing interventions within a long‐term care facility setting. The aim of this study was to describe the changes and influencing factors seen with a pharmacist‐led PPI deprescribing intervention in two Fraser Health Authority long‐term care facilities in British Columbia. Methods This 4‐month intervention involved lists of residents who had active PPI orders being handed out to physicians from two facilities. The pharmacist conducted weekly reviews of residents from Facility 1 and offered deprescribing recommendations. The number and methods of PPI deprescribing orders per facility were determined after the intervention. Results Out of 58 residents from the two facilities, 30 (62.5%) had a deprescribing order. Facility 1 had 83.3% (20/24) of residents with a PPI deprescribing order, in contrast to 41.7% (10/24) from Facility 2. Overall, 80.0% of residents had successfully completed PPI deprescribing orders by the end of the study period. Conclusion Clinical pharmacist intervention may increase the rate of initiation in PPI deprescribing orders within a long‐term care facility setting. Factors that influence success include intervention timing, active collaboration, having residents under direct care, and clear documentation of PPI indications.