Premium
Reported proton pump inhibitor side effects: what are physician and patient perspectives and behaviour patterns?
Author(s) -
Ghosh Gaurav,
SchnollSussman Felice,
Mathews Steven,
Katz Philip O.
Publication year - 2020
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.15522
Subject(s) - medicine , adverse effect , specialty , osteoporosis , proton pump inhibitor , odds ratio , side effect (computer science) , medline , family medicine , intensive care medicine , emergency medicine , computer science , political science , law , programming language
Summary Background Proton pump inhibitors (PPI) are among the most commonly prescribed medications and studies are reporting potentially harmful PPI‐related adverse events. While these studies’ findings are controversial, their impact on patients and physicians remains unknown. Aim To determine patient and physician awareness of PPI‐related adverse events, source of information, and subsequent effect on patient behaviour and physician practice. Methods A 20‐item questionnaire was administered to English speaking adult patients and physicians in primary care and specialty clinics about topics including knowledge of PPI‐related adverse events, change in behaviour of patients on PPIs and physician management of patients on PPIs. Results Of 277 patients surveyed, 45% reported knowledge of side effects related to PPIs. Patients were more likely to hear about PPI side effects from non‐physician sources (66%) than physicians (38%). Of patients who had heard about PPI side effects, bone fractures and osteoporosis were the most common concerns, 42% and 44% respectively. Of PPI users, 38% changed their behaviour based upon concerns about PPI‐related adverse events. Change in patient behaviour due to concern about PPI side effects was associated with age ≥ 65 years (odds ratio [OR] 4.07 [1.19‐13.94]; P = 0.03) and concern about long‐term side effects (OR 2.31 [1.03‐5.17]; P = 0.04). Of 83 physicians surveyed, 60% reported concern about PPI‐related adverse events, with bone fractures (46%) and osteoporosis (49%) being the most frequently reported. Overall, 37% of physicians reported changing their practice based upon their concerns. Conclusions Nearly half of patients reported knowledge of PPI‐related adverse events, most often from non‐physician sources, and general concern regarding their impact. PPI users are changing their behaviour based upon these concerns, without physician input, and care providers are changing behaviour based on relatively weak evidence.