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Sustained proton pump inhibitor deprescribing among dyspeptic patients in general practice: a return to self-management through a programme of education and alginate rescue therapy. A prospective interventional study

Cathal Coyle, Russell Symonds, Jane Allan, Sarah Dawson, Sheldon Russell, Adam Smith, Colin Daff and Helen Kotze
BJGP Open 2019; 3 (3): bjgpopen19X101651. DOI: https://doi.org/10.3399/bjgpopen19X101651
Cathal Coyle
1 Global Medical Affairs Lead, Global Medical Affairs, Reckitt Benckiser, Slough, Berkshire, UK
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  • ORCID record for Cathal Coyle
  • For correspondence: Cathal.Coyle@rb.com
Russell Symonds
2 NHS Business Manager, NHS team, Reckitt Benckiser, Slough, UK
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Jane Allan
3 Nurse Advisor, Ashfield: Patient Solutions, Ashfield Healthcare, Leicester, UK
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Sarah Dawson
4 Nurse Advisor, Ashfield: Patient Solutions, Ashfield Healthcare, Leicester, UK
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Sheldon Russell
5 Practice Support Pharmacist, Medicines Management, Barnet Clinical Commissioning Group, London, UK
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Adam Smith
6 Evidence and Outcomes Manager, Health Outcomes, Evidence Generation & Clinical Research, Reckitt Benckiser, Slough, UK
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Colin Daff
7 Assistant Director, Medicines Management, Barnet Clinical Commissioning Group, London, UK
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Helen Kotze
8 Global Medical Affairs Manager, Global Medical Affairs, Reckitt Benckiser, Slough, UK
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    Figure 1. Study protocol summary

    DTREP = Dyspepsia Therapy Review and Education Programme. PPI = proton pump inhibitor.

  • Figure 2.
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    Figure 2. DTREP impact on PPI use across regional PCOs in England, Scotland, and Wales

    The proportion of PPI-treated patients and change in PPI status are summarised for each study PCO.

    DNA = did not attend. DTREP = Dyspepsia Therapy Review and Education Programme. NLA = no longer active. PCO = primary care organisation (clinical commissioning group). PPI = proton pump inhibitor.

  • Figure 3.
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    Figure 3. Net impact of DTREP programme on prescriptions

    DTREP = Dyspepsia Therapy Review and Education Programme. PPI = proton pump inhibitor.

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    Table 1. Net impact of DTREP programme on proton pump inhibitor status
    OutcomePatients, n (%)
    Total eligible6249 (100)
    Step down Step down then off Step off only 2173 (34.8)312 (5.0)2206 (35.3)
    Total successful reduction 4691 (75.1)
    Did not attend Unsuccessful, reverted Under review and/or refused No longer active 520 (8.3)541 (8.7)163 (2.6)334 (5.3)
    Total reduction 1558 (24.9)
    • DTREP = Dyspepsia Therapy Review and Education Programme.

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October 2019
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Sustained proton pump inhibitor deprescribing among dyspeptic patients in general practice: a return to self-management through a programme of education and alginate rescue therapy. A prospective interventional study
Cathal Coyle, Russell Symonds, Jane Allan, Sarah Dawson, Sheldon Russell, Adam Smith, Colin Daff, Helen Kotze
BJGP Open 2019; 3 (3): bjgpopen19X101651. DOI: 10.3399/bjgpopen19X101651

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Sustained proton pump inhibitor deprescribing among dyspeptic patients in general practice: a return to self-management through a programme of education and alginate rescue therapy. A prospective interventional study
Cathal Coyle, Russell Symonds, Jane Allan, Sarah Dawson, Sheldon Russell, Adam Smith, Colin Daff, Helen Kotze
BJGP Open 2019; 3 (3): bjgpopen19X101651. DOI: 10.3399/bjgpopen19X101651
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Keywords

  • alginates
  • proton pump inhibitor
  • dyspepsia
  • primary health care
  • self-care

More in this TOC Section

  • Translating primary care to telehealth: analysis of in-person consultations on diabetes and cardiovascular disease
  • Primary care physicians’ perceptions of social determinants of health recommendations: a qualitative study
  • Ethnic minority GP trainees at risk for underperformance assessments: a quantitative cohort study
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