Evidence map›Paper›PMID 28500192›Full record

GuidelineCanadian family physician Medecin de famille canadien2017

Deprescribing proton pump inhibitors: Evidence-based clinical practice guideline.

Barbara Farrell, Kevin Pottie, Wade Thompson, Taline Boghossian, Lisa Pizzola, Farah Joy Rashid, Carlos Rojas-Fernandez, Kate Walsh, Vivian Welch, Paul Moayyedi

2 registry-linked trialsAbstract readPractice Guideline
PubMed Full text at PMC
In one paragraph

Guideline in Canadian family physician Medecin de famille canadien, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 224 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
224citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03689049 naactive not recruitingnot on this mapstarted 2018, after this paper: background citation

SPIDER: A Structured Process Informed by Data, Evidence and Research - A Research and Quality Improvement Collaboration Supporting Practices in Improving Care for Complex Elderly Patients

TypeinterventionalSponsorUniversity of Toronto Practice Based Research NetworkRan2018 to 2027Enrolled104ConditionsPolypharmacy, Inappropriate Prescribing, Aged, Primary Health CareArmsSPIDER, Usual Care
NCT06858384 narecruitingnot on this mapstarted 2025, after this paper: background citation

From Awareness to Action: Transforming Proton Pump Inhibitor Use in Ras Al Khaimah Through Education and Intervention: the RAK -PRIDE Study

TypeinterventionalSponsorRAK Medical and Health Sciences UniversityRan2025 to 2026Enrolled479ConditionsProton Pump Inhibitors, Deprescribing, Inappropriate UseArmsControl (Standard treatment), Pharmacist-Led Educational Intervention
3 · Its place in the literature

Who cites it

224 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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164 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Barbara FarrellAssistant Professor in the Department of Family Medicine at the University of Ottawa in Ontario, Adjunct Assistant Professor in the School of Pharmacy at the University of Waterloo in Ontario, and Scientist at the Bruyère Research Institute at the University of Ottawa. bfarrell@bruyere.org.
Kevin PottieAssociate Professor in the Department of Family Medicine and the School of Epidemiology, Public Health and Preventive Medicine at the University of Ottawa and Scientist at the Bruyère Research Institute.
Wade ThompsonMaster's student in the School of Epidemiology, Public Health and Preventive Medicine at the University of Ottawa at the time of guideline development.
Taline BoghossianResident in the Department of Pharmacy at the Ottawa Hospital at the time of guideline development.
Lisa PizzolaProject coordinator with the Bruyère Research Institute during guideline development.
Farah Joy RashidResident in the Department of Pharmacy at the Ottawa Hospital at the time of guideline development.
Carlos Rojas-FernandezSchlegel Research Chair in Geriatric Pharmacotherapy at the Schlegel-UW Research Institute on Ageing and the School of Pharmacy at the University of Waterloo at the time of guideline development.
Kate WalshPharmacist with the Toronto Central Community Care Access Centre in Ontario.
Vivian WelchDirector of the Methods Centre at the Bruyère Research Institute and Assistant Professor in the School of Epidemiology, Public Health and Preventive Medicine at the University of Ottawa.
Paul MoayyediDirector of the Division of Gastroenterology at McMaster University in Hamilton, Ont.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper or stop proton pump inhibitors (PPIs); to focus on the highest level of evidence available and seek input from primary care professionals in the guideline development, review, and endorsement processes.

methodsFive health professionals (1 family physician, 3 pharmacists, and 1 gastroenterologist) and 5 nonvoting members comprised the overall team; members disclosed conflicts of interest. The guideline process included the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach, with a detailed evidence review in in-person, telephone, and online meetings. Uniquely, the guideline development process included a systematic review of PPI deprescribing trials and examination of reviews of the harm of continued PPI use. Narrative syntheses of patient preferences and resource-implication literature informed recommendations. The team refined guideline content and recommendation wording through consensus and synthesized clinical considerations to address common front-line clinician questions. The draft guideline was distributed to clinicians and then to health care professional associations for review and revisions made at each stage. A decision-support algorithm was developed in conjunction with the guideline. RECOMMENDATIONS: This guideline recommends deprescribing PPIs (reducing dose, stopping, or using "on-demand" dosing) in adults who have completed a minimum of 4 weeks of PPI treatment for heartburn or mild to moderate gastroesophageal reflux disease or esophagitis, and whose symptoms are resolved. The recommendations do not apply to those who have or have had Barrett esophagus, severe esophagitis grade C or D, or documented history of bleeding gastrointestinal ulcers.

conclusionThis guideline provides practical recommendations for making decisions about when and how to reduce the dose of or stop PPIs. Recommendations are meant to assist with, not dictate, decision making in conjunction with patients.

Indexed as

DeprescriptionsAlgorithmsConsensusDecision Support TechniquesEvidence-Based PracticeGastrointestinal DiseasesHumansPolypharmacyPractice Patterns, Physicians'Proton Pump InhibitorsProton Pump Inhibitors

Identifiers

PMID28500192
PMCPMC5429051

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.