Evidence map›Paper›PMID 36854455›Full record

Observational studyCMAJ open

Prescribing, deprescribing and potential adverse effects of proton pump inhibitors in older patients with multimorbidity: an observational study.

Carole E Aubert, Manuel R Blum, Viktoria Gastens, Olivia Dalleur, Fanny Vaillant, Emma Jennings, Drahomir Aujesky, Wade Thompson, Tijn Kool, Cornelius Kramers and 3 more

Open access · diamondAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
3.9field-weighted citation impact, top 6% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Observational
  10. Article
  11. Review
  12. Transoral incisionless fundoplication and open hiatal hernia repair: A case report.Frontiers in gastroenterology (Lausanne, Switzerland) · 2023
    Article
  13. Proton Pump Inhibitors in Germany: Status Quo of a Growing Market.Health services research and managerial epidemiology
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 5 countries.

Carole E AubertDepartment of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O'Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women's College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands caroleelodie.aubert@insel.ch.
Manuel R BlumDepartment of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O'Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women's College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands.
Viktoria GastensDepartment of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O'Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women's College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands.
Olivia DalleurDepartment of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O'Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women's College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands.
Fanny VaillantDepartment of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O'Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women's College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands.
Emma JenningsDepartment of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O'Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women's College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands.
Drahomir AujeskyDepartment of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O'Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women's College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands.
Wade ThompsonDepartment of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O'Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women's College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands.
Tijn KoolDepartment of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O'Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women's College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands.
Cornelius KramersDepartment of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O'Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women's College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands.
Wilma KnolDepartment of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O'Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women's College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands.
Denis O'MahonyDepartment of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O'Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women's College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands.
Nicolas RodondiDepartment of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O'Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women's College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands.
University of Bern · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProton pump inhibitors (PPIs) contribute to polypharmacy and are associated with adverse effects. As prospective data on longitudinal patterns of PPI prescribing in older patients with multimorbidity are lacking, we sought to assess patterns of PPI prescribing and deprescribing, as well as the association of PPI use with hospital admissions over 1 year in this population.

methodsWe conducted a prospective, longitudinal cohort study using data from the Optimizing Therapy to Prevent Avoidable Hospital Admissions in Multimorbid Older Adults (OPERAM) trial, a randomized controlled trial testing an intervention to reduce inappropriate prescribing (2016-2018). This trial included adults aged 70 years and older with at least 3 chronic conditions and prescribed at least 5 chronic medications. We assessed prevalence of PPI use at time of hospital admission, and new prescriptions and deprescribing at discharge, and at 2 months and 1 year after discharge, by intervention group. We used a regression with competing risk for death to assess the association of PPI use with readmissions related to their potential adverse effects, and all-cause readmission.

resultsOverall, 1080 (57.4%) of 1879 patients (mean age 79 yr) had PPI prescriptions at admission, including 496 (45.9%) patients with a potentially inappropriate indication. At discharge, 133 (24.9%) of 534 patients in the intervention group and 92 (16.8%) of 546 patients in the control group who were using PPIs at admission had deprescribing. Among 680 patients who were not using PPIs at discharge, 47 (14.6%) of 321 patients in the intervention group and 40 (11.1%) of 359 patients in the control group had a PPI started within 2 months. Use of PPIs was associated with all-cause readmission (

interpretationPotentially inappropriate use of PPI, new PPI prescriptions and PPI deprescribing were frequent among older adults with multimorbidity and polypharmacy. These data suggest that persistent PPI use may be associated with clinically important adverse effects in this population.

Indexed as

DeprescriptionsProton Pump InhibitorsAgedAged, 80 and overHumansLongitudinal StudiesMultimorbidityProspective StudiesRandomized Controlled Trials as TopicProton Pump Inhibitors

Identifiers

PMID36854455
PMCPMC9981164
OpenAlexW4322708822

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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.