Guiding Safe Reduction of Inappropriate Proton Pump Inhibitors in Adults in Swiss Primary Care The DROPIT Cluster-Randomized Trial

What this Trial Is About

This research aims to evaluate an intervention to guide the deprescribing of inappropriate proton pump inhibitors PPIs in adult patients within a Swiss primary care setting. The study investigates whether this intervention can safely reduce inappropriate PPI prescriptions compared to usual care, while also assessing its impact on clinical outcomes, implementation factors, and cost-effectiveness. PPIs are commonly used for gastric acid-related disorders, but concerns exist about their long-term inappropriate use and associated risks such as nutritional deficiencies and infections. The trial is an interventional, open-label, cluster-randomized controlled study involving general practitioners GPs and their adult patients who have been using PPIs daily for at least 8 weeks at specified doses. Patients are assigned by GP clusters to either receive the deprescribing intervention, which includes educational materials and guidance for both GPs and patients, or to continue with usual care without the intervention. The study follows participants for 12 months to monitor PPI use and safety outcomes. Participants will be involved in regular follow-up over 12 months to evaluate PPI dosage changes, gastrointestinal symptoms, quality of life, medication use, and safety events. Data will be collected on PPI dose reductions, discontinuations, switches to on-demand use, and alternative treatments. The study also includes assessments of the interventions implementation quality, acceptance by patients and GPs, and cost-effectiveness. Safety and effectiveness will be analyzed using statistical models accounting for cluster randomization and baseline measures.

Deprescribing Inappropriate Proton Pump Inhibitors