dc.contributor |
Háskóli Íslands |
dc.contributor |
University of Iceland |
dc.contributor.author |
Bruno, Claudia |
dc.contributor.author |
Pearson, Sallie-Anne |
dc.contributor.author |
Daniels, Benjamin |
dc.contributor.author |
Buckley, Nicholas A |
dc.contributor.author |
Schaffer, Andrea |
dc.contributor.author |
Zoega, Helga |
dc.date.accessioned |
2020-05-14T15:33:07Z |
dc.date.available |
2020-05-14T15:33:07Z |
dc.date.issued |
2020-04-20 |
dc.identifier.citation |
Bruno C, Pearson S, Daniels B, et alPassing the acid test? Evaluating the impact of national education initiatives to reduce proton pump inhibitor use in AustraliaBMJ Quality & Safety 2020;29:365-373. |
dc.identifier.issn |
2044-5415 |
dc.identifier.issn |
2044-5423 (eISSN) |
dc.identifier.uri |
https://hdl.handle.net/20.500.11815/1799 |
dc.description |
Publisher's version (útgefin grein) |
dc.description.abstract |
Background Proton pump inhibitor (PPI) use is widespread. There have been increasing concerns about overuse of high-dose PPIs for durations longer than clinically necessary. Objective To evaluate the impact of national education initiatives on reducing PPI use in Australia. Design Population-based, controlled interrupted time series analysis of PPI dispensing claims data for Australian adults from July 2012 to June 2018; we used statin dispensing as a control. Interventions A year-long educational initiative led by NPS MedicineWise (previously the National Prescribing Service) from April 2015. Simultaneously, Choosing Wisely released recommendations in April 2015 and May 2016. Both promoted review of prolonged PPI use and encouraged stepping down or ceasing treatment, where appropriate. Measurements We examined monthly changes in PPI (and statin) dispensing (stratified by high, standard and low tablet strength), rates of switching from higher to lower strength PPIs and rates of PPI (and statin) discontinuation. Results We observed 12 040 021 PPI dispensings to 579 594 people. We observed a sustained -1.7% (95% CI: -2.7 to -0.7%) decline in monthly dispensing of standard strength PPIs following the initiatives until the end of the study period. There were no significant changes in high or low strength PPI (or statin) dispensings, switching to lower strength PPIs, or PPI (and statin) treatment discontinuation. Conclusion Our findings suggest that these educational initiatives alone were insufficient in curbing overuse of PPIs on a national level. Concerted efforts with policy levers such as imposing tighter restrictions on subsidised use of PPIs may be more effective. Noting low strength esomeprazole is not publicly subsidised in Australia, availability of these preparations may also facilitate more appropriate practice |
dc.description.sponsorship |
This research is supported by the National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Medicines and Ageing (ID: 1060407) and a Cooperative Research Centre Project (CRC-P) Grant from the Australian Government Department of Industry, Innovation and Science (ID: CRC-P-439). Dr Zoega was supported by a Scientia Fellowship from UNSW Sydney. Dr Schaffer was supported by a NHMRC Early Career Fellowship (#1158763). |
dc.format.extent |
365-373 |
dc.language.iso |
en |
dc.publisher |
BMJ |
dc.relation.ispartofseries |
BMJ Quality & Safety;29(5) |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.subject |
Health policy |
dc.subject |
Health services research |
dc.subject |
Healthcare quality improvement |
dc.subject |
Pharmacoepidemiology |
dc.subject |
Heilbrigðisstefna |
dc.subject |
Heilbrigðisþjónusta |
dc.subject |
Lyfjafræði |
dc.subject |
Faraldsfræði |
dc.title |
Passing the acid test? Evaluating the impact of national education initiatives to reduce proton pump inhibitor use in Australia |
dc.type |
info:eu-repo/semantics/article |
dcterms.license |
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
dc.description.version |
Peer Reviewed |
dc.identifier.journal |
BMJ Quality & Safety |
dc.identifier.doi |
10.1136/bmjqs-2019-009897 |
dc.relation.url |
https://syndication.highwire.org/content/doi/10.1136/bmjqs-2019-009897 |
dc.contributor.department |
Læknadeild (HÍ) |
dc.contributor.department |
Faculty of Medicine (UI) |
dc.contributor.school |
Heilbrigðisvísindasvið (HÍ) |
dc.contributor.school |
School of Health Sciences (UI) |