The following is a summary of “Determinants of and Interventions for Proton Pump Inhibitor Prescription Behavior: A Systematic Scoping Review,” published in the June 2024 issue of Primary Care by Gestel et al.
Proton Pump Inhibitors (PPIs) are widely prescribed medications known for their efficacy in managing acid-related disorders. However, concerns have grown regarding their overprescription and prolonged use, which can lead to adverse effects without clear clinical justification. This systematic scoping review aims to delve into several critical aspects surrounding PPI prescribing practices: first, by exploring the various determinants that influence physicians’ decisions to prescribe PPIs; second, by examining the strategies employed to alter these prescribing behaviors, particularly focusing on initiatives aimed at deprescribing or reducing unnecessary PPI use; and third, by evaluating the extent to which these interventions address the underlying determinants identified.
The review encompassed a thorough search across eight major databases, identifying and synthesizing findings from 74 studies conducted predominantly in Western countries and targeting adult populations. Using the theoretical framework provided by the Behaviour Change Wheel, the researchers systematically extracted and analyzed data related to the behavioral determinants influencing PPI prescribing practices and the effectiveness of intervention strategies designed to modify these behaviors.
Among the determinants influencing PPI prescribing behaviors, significant attention was placed on physicians’ knowledge levels and beliefs regarding PPI use’s consequences. Notably, beliefs about the benefits versus risks of long-term PPI use consistently emerged as influential factors. While studies evaluating knowledge yielded mixed results, the impact of beliefs on prescribing practices was more consistently observed across the literature.
In terms of intervention strategies, educational initiatives aimed at enhancing physicians’ understanding of appropriate PPI use were commonly employed. Additionally, enablement strategies such as the implementation of clinical algorithms, quality improvement measures within healthcare settings, and the involvement of pharmacists in medication review processes were identified. These enablement strategies showed more consistent effectiveness in promoting appropriate PPI prescribing behaviors compared to purely educational interventions, which varied in their impact depending on the specific context and implementation.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02459-5
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