Department of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, PO Box 3030, Irbid, 22110, Jordan.
Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan.
BMC Geriatr. 2020 Oct 29;20(1):431. doi: 10.1186/s12877-020-01844-w.
BACKGROUND: Proton pump inhibitors (PPIs) are effective in treating gastroesophageal reflux, peptic ulcers, and esophagitis. However, the long-term use of PPIs by older adults is associated with adverse health outcomes. There is limited evidence about older adults' awareness of long-term PPI use and its associated adverse effects. This study aimed to assess older adults' awareness of the adverse effects of the long-term use of PPIs, and their willingness to stop PPI use given of the risks and benefits of PPI use. METHODS: this cross-sectional study was conducted on a convenience sample of 120 older adults from three local healthcare centers located in Irbid, Jordan. Older adults' awareness of PPI use was measured using the Patients' Perceptions of Proton Pump Inhibitor Risks and Attempts at Discontinuation Survey. RESULTS: the majority of the participating older adults were not familiar with any reports linking long-term PPI use with adverse effects, reported no concerns related to the chronic use of PPIs, and reported that they had not discussed the benefits and risks of PPI use with their primary care providers (PCPs). Although the majority of the participants had not previously attempted to stop using PPIs, the majority expressed a willingness to stop PPIs due to their adverse effects, especially if advised to do so by a PCP. The factors associated with the long-term use of PPIs included age, indications for gastrointestinal reflux disease (GERD), improvement of GERD symptoms, and the willingness to reduce or stop PPIs. Being advised by a PCP to stop PPIs (p = 0.049) and having increased concerns about the adverse effects of long-term PPI use (p < 0.0001) were the only two statistically significant predictors of previous attempts to stop PPIs. CONCLUSIONS: concerns regarding the adverse effects of long-term PPI use were associated with attempts to stop PPIs, especially in cases where this was recommended by a PCP. Discussions between PCPs and patients regarding the risks and benefits of PPIs are necessary in order to ensure that patients do not make inappropriate decisions regarding ongoing PPI therapy. Careful evaluation of the long-term use of PPIs among older adults is required.
背景：质子泵抑制剂（PPIs）在治疗胃食管反流、消化性溃疡和食管炎方面非常有效。然而，老年人长期使用 PPI 与不良健康后果有关。关于老年人对长期使用 PPI 及其相关不良反应的认识的证据有限。本研究旨在评估老年人对长期使用 PPI 的不良反应的认识，以及在权衡 PPI 使用的风险和益处后，他们停止使用 PPI 的意愿。
方法：这是一项在约旦伊尔比德的三个当地医疗中心的便利样本中进行的横断面研究，共纳入 120 名老年人。使用“患者对质子泵抑制剂风险的认知和停药尝试调查”来评估老年人对 PPI 使用的认知。
结果：大多数参与的老年人对任何将长期使用 PPI 与不良反应联系起来的报告都不熟悉，对慢性使用 PPI 没有任何担忧，并表示他们没有与初级保健提供者（PCP）讨论 PPI 使用的益处和风险。尽管大多数参与者之前没有尝试停止使用 PPI，但大多数人表示，如果 PCP 建议，他们愿意因不良反应而停止使用 PPI。与长期使用 PPI 相关的因素包括年龄、胃肠道反流病（GERD）的指征、GERD 症状的改善以及减少或停止 PPI 的意愿。由 PCP 建议停止 PPI（p=0.049）和对长期使用 PPI 的不良反应增加担忧（p<0.0001）是唯一两个与之前尝试停止 PPI 相关的统计学显著预测因素。
结论：对长期使用 PPI 的不良反应的担忧与停止使用 PPI 的尝试有关，特别是在 PCP 建议的情况下。PCP 和患者之间需要讨论 PPI 的风险和益处，以确保患者不会对正在进行的 PPI 治疗做出不适当的决定。需要对老年人长期使用 PPI 进行仔细评估。
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