Magnitude and Determinants of Long-term Use of Proton Pump Inhibitors Among Portuguese Older Adults in Primary Health Care

Daniela A Rodrigues; Maria Teresa Herdeiro; Ramona Mateos-Campos; Adolfo Figueiras; Fátima Roque

doi:10.1016/j.clinthera.2023.11.011

Magnitude and Determinants of Long-term Use of Proton Pump Inhibitors Among Portuguese Older Adults in Primary Health Care

Clin Ther. 2024 Feb;46(2):e54-e58. doi: 10.1016/j.clinthera.2023.11.011. Epub 2023 Dec 6.

Authors

Daniela A Rodrigues¹, Maria Teresa Herdeiro², Ramona Mateos-Campos³, Adolfo Figueiras⁴, Fátima Roque⁵

Affiliations

¹ Research Laboratory on Epidemiology and Population Health, Polytechnic of Guarda (IPG), 6300-559, Guarda, Portugal; Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 6200-506, Covilhã, Portugal; PhD Student, University of Salamanca, 37007, Salamanca, Spain.
² Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193, Aveiro, Portugal.
³ Area of Preventive Medicine and Public Health, Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37007, Salamanca, Spain.
⁴ Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15702, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (IDIS), 15706, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), 28001, Madrid, Spain.
⁵ Research Laboratory on Epidemiology and Population Health, Polytechnic of Guarda (IPG), 6300-559, Guarda, Portugal; Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 6200-506, Covilhã, Portugal. Electronic address: froque@ipg.pt.

PMID: 38061931
DOI: 10.1016/j.clinthera.2023.11.011

Abstract

Purpose: Proton Pump Inhibitors (PPIs) have been associated with several adverse effects of particular concern in older populations. Their use for a period longer than 8 weeks is not recommended for older adults. Strategies to discontinue PPIs have been offered; however, their use remains high. This study aims to characterize PPI use in Portuguese older people and to identify the factors associated with potentially inappropriate use.

Methods: A cross-sectional study was conducted on 1200 randomly selected older adults (≥65 years of age), users of primary health care facilities in the Regional Health Administration (Administração Regional de Saúde of Centro [ARSC]) of Portugal between April 2021 and August 2022. Data concerning their characteristics and PPI use were provided by the Shared Services of the Health Ministry (Serviços Partilhados do Ministério da Saúde) and collected retrospectively. Associations between independent variables and PPI use were investigated by logistic regression analysis.

Findings: Of the older adults, 37.92% were receiving PPIs and 78.68% of them were taking them for a longer period than recommended; 49.79% were taking PPIs without having any digestive system-related disease. Multivariate analysis showed that the prolonged use of PPIs was not associated with any specific pattern, although inappropriate PPI use is high among Portuguese older adults.

Implications: Long-term PPI use in older adults is widespread and does not fit any particular patient profile; therefore, cross-cutting educational interventions should be designed independently of the patient's pathologic condition or treatment.

Keywords: Long-term use; Older adults; Portugal; Proton pump inhibitors.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cross-Sectional Studies
Gastrointestinal Diseases* / chemically induced
Humans
Portugal
Primary Health Care
Proton Pump Inhibitors* / adverse effects
Retrospective Studies

Substances

Proton Pump Inhibitors