ArticleBJGP open2019
Sustained proton pump inhibitor deprescribing among dyspeptic patients in general practice: a return to self-management through a programme of education and alginate rescue therapy. A prospective interventional study.
Article in BJGP open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effective deprescribing strategies for reducing potentially inappropriate medications and improving economic outcomes in community-based settings: a systematic review and meta-analysis.BMC health services research · 2026Pooled it
- Effectiveness of Patient-Directed Education to Sustain Deprescribing: A Pragmatic Trial.Drugs & aging · 2025Trial
- Low-value chronic prescription of acid reducing medication among Dutch general practitioners: impact of a patient education intervention.BMC primary care · 2024Trial
- Efficacy of a computer based discontinuation strategy to reduce PPI prescriptions: a multicenter cluster-randomized controlled trial.Scientific reports · 2023Trial
- Randomised clinical trial: the use of alginates during preinvestigation proton pump inhibitor wash-out and their impact on compliance and symptom burden.BMJ open gastroenterology · 2023Trial
- Rethinking proton pump inhibitor deprescribing: from tapering strategies to patient-centered management.Journal of gastroenterology · 2026Article
- Internists' deprescribing behavior for proton pump inhibitor therapy: a qualitative study based on the theoretical domains framework internists' deprescribing behavior for PPI therapy.BMC health services research · 2026Article
- Article
- Self-Management of Reflux-Like Symptoms: A Patient-Centered Decision-Making Approach.Digestive diseases (Basel, Switzerland) · 2026Review
- Budget Impact Analysis of Stepping Down Patients from Long-Term Inappropriate Proton Pump Inhibitor Use to Episodic Alginate Treatment: NHS England Perspective.Journal of health economics and outcomes research · 2025Article
- Prescribing practices for proton pump inhibitors among primary care physicians in England: an evaluation.BJGP open · 2025Article
- Approaches to Deprescribing Proton Pump Inhibitors in Clinical Practice: A Systematic Review.Journal of clinical medicine · 2024Review
- Rebound Acid Hypersecretion after Withdrawal of Long-Term Proton Pump Inhibitor (PPI) Treatment-Are PPIs Addictive?International journal of molecular sciences · 2024Review
- Assessment and treatment of reflux-like symptoms in the community: a multidisciplinary perspective.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Proton Pump Inhibitors: Rational Use and Use-Reduction - The Windsor Workshop.Digestive diseases (Basel, Switzerland) · 2024Review
- Improving the feasibility of deprescribing proton pump inhibitors: GPs' insights on barriers, facilitators, and strategies.Frontiers in pharmacology · 2024Article
- Analysis of deprescription strategies of proton pump inhibitors in primary care: a narrative review.Primary health care research & development · 2023Review
- Holistic management of symptomatic reflux: rising to the challenge of proton pump inhibitor overuse.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Review article: rethinking the "ladder" approach to reflux-like symptom management in the era of PPI "resistance" - a multidisciplinary perspective.Alimentary pharmacology & therapeutics · 2022Review
- The tapestry of reflux syndromes: translating new insight into clinical practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDyspepsia guidelines recommend that patients treated with proton pump inhibitors (PPIs) should step down to the lowest effective dose or return to self-care, but rebound hyperacidity can make this difficult. Many patients continue on PPIs in the long term, which may lead to safety and financial implications.
aimTo determine if a nurse-led educational support programme and rescue therapy for rebound symptoms can help patients achieve a sustained reduction in PPI use. DESIGN &
settingA prospective interventional study was conducted at 26 surgeries across the UK.
methodAdult patients, treated with PPIs for ≥2 consecutive months with an active repeat prescription, were invited to a 20-minute dyspepsia clinic appointment with a trained nurse adviser. An action plan to reduce and/or stop their PPI usage was agreed and alginate supplied for the self-management of rebound symptoms. After 12 months, PPI status was reviewed and prescribing cost savings calculated.
resultsAfter 12 months, 75.1% of 6249 eligible patients stepped down or off PPIs (35.3% stepped off; 5.0% stepped down then off; 34.8% stepped down only), while 8.7% of patients had reverted to their original PPI dose. PPI prescriptions fell from 89 915 to 45 880 and alginate prescriptions increased from 2405 to 6670. An average of 1.7 bottles (500 ml each) of alginate were used per patient who stepped down or off. Estimated annual cost-saving on prescriptions was £31 716.30.
conclusionA programme of education and short-term rebound symptom management helped the majority of patients to successfully step down or off PPIs, significantly reducing the potential risks associated with chronic therapy.
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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.