Evidence map›Paper›PMID 40296703›Full record

ArticlePharmacoepidemiology and drug safety2025

Proton Pump Inhibitor Use Exceeding the U.S. Food and Drug Administration Approved Treatment Duration for Patients With Peptic Ulcer Disease: A Retrospective Cohort Study.

Jordan A Villars, Timothy S Anderson, Jonathan G Yabes, Robert E Schoen, Ravy K Vajravelu

Abstract read
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Jordan A VillarsDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Timothy S AndersonDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Jonathan G YabesDivision of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Robert E SchoenDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Ravy K VajraveluDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-6557-3307

Funding

Optimizing prescribing decisions for hospitalized older adults with chronic conditionsK76AG074878 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Timothy S Anderson · 2022 to 2026
$1.2M
Evaluation of multiple medication exposures concurrently using a novel algorithmK08DK119475 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI VAJRAVELU, RAVY KUPPALAPALLE · 2019 to 2023
$797k
NIA NIH HHS K76 AG074878NIDDK NIH HHS K08 DK119475NIH HHSNIH/NIA K76-AG074878NIH/NIDDK K08-DK119475
6 · The paper itself

Abstract

backgroundProton-pump inhibitors (PPIs) are effective in treating peptic ulcer disease (PUD), but they are often prescribed beyond the approved duration. Because PPIs are associated with adverse effects, there is a need for effective stewardship.

objectiveTo identify the frequency of and healthcare factors associated with PPI prescriptions exceeding the approved eight-week treatment duration for PUD.

methodsWe conducted a retrospective cohort study of patients diagnosed with acute PUD without other indications for PPI use using data from the Veterans Health Administration in the United States. Exposures were patient, provider, and facility factors that could influence PPI prescribing. The outcome was time to a filled PPI prescription exceeding the approved treatment duration for PUD. Associations were assessed using a multivariable time-to-recurrent-event model to calculate adjusted hazard ratios (aHR) and population-attributable fractions. Patients who developed indications for long-term PPI use were censored.

resultsWe identified 7708 patients with PUD who met eligibility criteria and received PUD treatment (median age 79 [IQR 71-85], 7% female). Thirty-five percent had PPI prescriptions exceeding the approved duration for a median of 346 days (IQR 165-643) of overuse. On the patient level, inpatient PUD diagnosis (aHR 1.32, 95% CI 1.25-1.39), use of nonsteroidal anti-inflammatory drugs (NSAIDs) (aHR 1.26, 95% CI 1.18-1.34), use of anticoagulants (aHR 1.25, 95% CI 1.13-1.38), and moderate frailty (1.15, 95% CI 1.06-1.26) had the strongest associations with filled PPI prescriptions exceeding the approved duration. On the health-system level, inpatient PUD diagnosis had the highest peak population attributable fraction at 0.26, followed by NSAIDs and anticoagulants at 0.18.

conclusionsMarkers of patient complexity and medication use not meeting gastroprotection guidelines are associated with inappropriate PPI persistence among patients with PUD. These data may inform future targeted PPI deprescribing programs.

Indexed as

Peptic UlcerPractice Patterns, Physicians'Proton Pump InhibitorsAgedAged, 80 and overCohort StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesTime FactorsUnited StatesUnited States Department of Veterans AffairsUnited States Food and Drug AdministrationProton Pump Inhibitorsdeprescribingoveruseproton pump inhibitors

Identifiers

PMID40296703
PMCPMC12038380

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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.