Logo do repositório
 
Publicação

Effectiveness of a collaborative deprescribing intervention of proton pump inhibitors on community-dwelling older adults

2025-12Artigo científico Acesso aberto
Ver registo simples
dc.contributor.authorRomano, Sónia
dc.contributor.authorRodrigues, António Teixeira
dc.contributor.authorGuerreiro, José Pedro
dc.contributor.authorSimões, João Braga
dc.contributor.authorGuerreiro, Isabel
dc.contributor.authorMonteiro, Luis
dc.contributor.authorLunet, Nuno
dc.contributor.authorPerelman, Julian
dc.contributor.institutionCentro de Investigação em Saúde Pública (CISP/PHRC)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - Pólo ENSP
dc.contributor.institutionEscola Nacional de Saúde Pública (ENSP)
dc.contributor.pblAdis International Ltd
dc.date.accessioned2026-01-14T15:54:51Z
dc.date.available2026-01-14T15:54:51Z
dc.date.issued2025-12
dc.descriptionPublisher Copyright: © The Author(s) 2025.
dc.description.abstractBackground: Proton pump inhibitors (PPIs) are commonly used and often prescribed inappropriately, which increases the risk of adverse events. Deprescribing is a health professional-supervised intervention aimed at reducing or discontinuing medications that may cause harm or no longer provide benefits. Objective: To evaluate the effectiveness of a collaborative intervention involving community pharmacists and general practitioners in deprescribing inappropriate PPIs (ATC/WHO A02BC) among community-dwelling older adults (aged ≥ 65 years). Methods: This was a pragmatic, multicentre, non-randomised two-arm-controlled trial with 6-month follow-up in Portuguese primary care, involving community pharmacies and family health units (FHUs) to deprescribe long-term PPIs (> 8 weeks). The intervention comprised a pharmacy-based patient awareness and education approach, followed by a clinical assessment by general practitioners to assess inappropriate use and initiate the deprescribing process, along with pharmacy-based follow-up to monitor the withdrawal process. The comparator was usual care. The primary outcome was successful deprescribing, defined as the discontinuation or dose reduction of any PPI at 3 and 6 months. Secondary measurements included clinical and drug-specific outcomes. An intention-to-treat analysis was performed. Results: The study included 166 patients (mean age 74.2 years (SD 6.0 years), 59.0% female) who had been using PPIs for an average of 10.6 years (SD 7.3 years). The intervention was found to be effective in reducing PPIs use. At 3 months, the adjusted absolute risk difference in deprescribing between the intervention group (IG) and the control group (CG) was 46.3% (95% confidence interval (CI) 32.8-59.9, number needed to treat of 2.2). The relative risk of deprescribing in the IG compared with the CG was 9.6 (95% CI 3.6–25.6). At the 6-month follow-up, the effect remained similar. No significant differences between the IG and CG were observed for secondary outcomes. Conclusions: This collaborative deprescribing intervention has been effective in reducing inappropriate PPI use, highlighting the need for ongoing multidisciplinary efforts and supportive policies to optimise medication use in older adults. Larger trials with longer follow-ups are necessary for a better assessment of various patient-reported outcomes and the long-term impact of these deprescribing interventions. Clinical Trial Registration: ISRCTN49637686, 14/06/2023 “retrospectively registered”.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent15
dc.format.extent1902481
dc.identifier.doi10.1007/s40266-025-01259-5
dc.identifier.issn1170-229X
dc.identifier.otherPURE: 148966330
dc.identifier.otherPURE UUID: 99893906-90ac-44b0-801c-8617735789d0
dc.identifier.otherScopus: 105020425120
dc.identifier.otherPubMed: 41176548
dc.identifier.otherWOS: 001607009800001
dc.identifier.otherPubMedCentral: PMC12660339
dc.identifier.urihttp://hdl.handle.net/10362/199051
dc.identifier.urlhttps://www.scopus.com/pages/publications/105020425120
dc.language.isoeng
dc.peerreviewedyes
dc.subjectGeriatrics and Gerontology
dc.subjectPharmacology (medical)
dc.subjectSDG 3 - Good Health and Well-being
dc.titleEffectiveness of a collaborative deprescribing intervention of proton pump inhibitors on community-dwelling older adultsen
dc.title.subtitlethe C-SENIoR pragmatic non-randomised controlled trialen
dc.typejournal article
degois.publication.firstPage1169
degois.publication.issue12
degois.publication.lastPage1183
degois.publication.titleDrugs and Aging
degois.publication.volume42
dspace.entity.typePublication
rcaap.rightsopenAccess

Ficheiros

Principais
A mostrar 1 - 1 de 1
Miniatura
Nome:
Romano_2025_Drugs_Aging_42_12_1169.pdf
Tamanho:
1.81 MB
Formato:
Adobe Portable Document Format
Ver/Abrir

Coleções

Home collection (ENSP)