Rudelle Karen, Laroche Marie-Laure
Département universitaire de médecine générale, faculté de médecine, 2, rue du Docteur-Marcland, 87025 Limoges, France; Inserm 1248, faculté de médecine, 87025 Limoges, France.
Inserm 1248, faculté de médecine, 87025 Limoges, France; Service de pharmacologie-toxicologie et pharmacovigilance, centre de pharmacovigilance, de pharmacoépidémiologie et d'information sur les médicaments, CHU de Limoges, 87042 Limoges, France.
Therapie. 2020 May-Jun;75(3):253-260. doi: 10.1016/j.therap.2019.07.008. Epub 2019 Aug 1.
Proton pump inhibitors (PPIs) are frequently prescribed by general practitioners (GPs) who consider these drugs to be safe. However, more and more adverse drug reactions (ADRs) associated with PPIs are described.
To determine the level of knowledge and attitude of GPs with respect to the ADRs of PPIs in adults.
The GPs of the Nouvelle-Aquitaine region and the chief residents or former chief residents of the 35 French university departments of general medicine were questioned online using a list of 12 ADRs based on a semi-systematic literature review (neutropenia, thrombocytopenia, anemia, hypomagnesemia, increased liver enzymes, renal failure, pneumonitis, skin reactions, fracture, gastric polyps, microscopic colitis, Clostridium difficile colitis) and their attitude towards these ADRs.
Out of the 232 (7.5%) GPs who participated, 38.4% had come across PPI ADRs (mainly digestive) in the last 6 months. These ADRs had been reported to pharmacovigilance in only 2.3% of the cases. No ADR at all was known by more than 70% of the GPs. The attitude of the GPs who had identified them was, in the majority, to stop PPI treatement. No difference in knowledge was found between university supervisors and non-supervisors. Finally, 74.7% of GPs declared that they required more information on IPP ADRs and 80.4% were willing to "deprescribe" these drugs.
Aside from digestive ADRs, GPs have a poor knowledge of IPP-related ADRs. Those who do know them have an appropriate attitude and interrupt IPP treatment. The information requested by the GPs about the risks of PPIs is pertinent, particularly in a PPI-adapted prescription procedure, which also involves knowing how to "deprescribe".
全科医生（GP）经常开具质子泵抑制剂（PPI），他们认为这些药物是安全的。然而，越来越多与PPI相关的药物不良反应（ADR）被报道。
确定全科医生对成人PPI不良反应的认知水平和态度。
通过基于半系统文献综述的12种ADR列表（中性粒细胞减少、血小板减少、贫血、低镁血症、肝酶升高、肾衰竭、肺炎、皮肤反应、骨折、胃息肉、显微镜下结肠炎、艰难梭菌结肠炎），对新阿基坦地区的全科医生以及法国35个大学普通医学系的住院总医师或 former chief residents进行在线询问，以及他们对这些ADR的态度。
在参与的232名（7.5%）全科医生中，38.4%在过去6个月中遇到过PPI ADR（主要是消化系统的）。这些ADR仅在2.3%的病例中被报告给药物警戒部门。超过70%的全科医生对任何ADR都一无所知。识别出这些ADR的全科医生的态度，大多数是停止PPI治疗。在大学督导员和非督导员之间未发现知识差异。最后，74.7%的全科医生表示他们需要更多关于PPI ADR的信息，80.4%愿意“停用”这些药物。
除了消化系统ADR外，全科医生对与PPI相关的ADR了解甚少。那些了解这些ADR的人态度恰当，并中断PPI治疗。全科医生要求的关于PPI风险的信息是相关的，特别是在适合PPI的处方程序中，这也涉及到知道如何“停用”。
