PPIs in GORD: a stepped approach
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Review your proton pump inhibitor (PPI) prescribing for patients with gastro-oesophageal reflux disease (GORD) and be guided on implementing an effective step-down approach for your patients.About
Quality Use of Medicines (QUM) principles include choosing an appropriate medicine when it is considered necessary, as well as using it safely and effectively. This Clinical e-Audit focuses on proton pump inhibitors (PPIs) to illustrate QUM principles when prescribing, including starting, stepping down and stopping medicines when appropriate.
Long-term regular use of PPIs is only indicated in certain circumstances, but PPIs continue to be one of the most widely prescribed classes of medicines in Australia. Two PPI medicines were included in the top five medicines by prescription volume in 2016–17. This Clinical e-Audit is designed to help you reflect on your PPI prescribing patterns for patients with GORD and will guide you to:
- start PPI treatment for 4–8 weeks only and discuss treatment expectations with each patient
- consider the evidence for rare but serious adverse effects associated with PPI use
- refresh your knowledge of lifestyle factors that may worsen GORD and help you implement tailored lifestyle and dietary modifications
- engage your patients in effectively stepping down or stopping treatment, including strategies to manage potential rebound acid hypersecretion.
Our Clinical e-Audits are free quality improvement activities that help GPs review their current prescribing practice for patients with certain conditions, compared with current best practice guidelines.
- completing electronic data collection for 10 patients
- submitting de-identified data securely online
- reflecting on patient-specific feedback provided to assist implementation of changes to practice
- reviewing individual and peer feedback results, based on achievement of best practice clinical indicators
- recording progress of individual patients automatically identified for review
- reflecting on improvements in your practice.
Participation in this activity will help you:
- implement the recommended treatment approach for GORD by starting with a standard-dose PPI for 4–8 weeks
- develop a plan with the patient that includes a review date, information about stepping down and lifestyle modifications
- manage the patient’s individual lifestyle factors and current medicines that can worsen GORD symptoms
- review the need for ongoing treatment with the aim of effectively stepping down and managing potential rebound acid hypersecretion.
- have access to a summary of best practice recommendations
- receive practical advice to provide to your patients
- create an individualised management plan for each patient
- receive immediate feedback and be able to compare your results with those of your peers.