OVERPRESCRIPTION OF PROTON PUMP INHIBITORS: CAUSES, CONSEQUENCES AND STRATEGIES FOR RATIONAL USE

Zuzanna Taciak; Anna-Maria  Grzeczka; Katarzyna  Pinkowska; Weronika  Nawrocka; Zuzanna  Korbel; Mikołaj  Jaszowski; Inez  Michalska; Agnieszka  Dąbrowska; Patrycja  Pietraszkiewicz; Paula  Żak; Filip  Glista

doi:10.31435/ijitss.2(50).2026.5673

Authors

Zuzanna Taciak Medical Center HCP, Poznań, Poland https://orcid.org/0009-0004-3101-009X
Anna-Maria Grzeczka Wielospecjalistyczny Szpital Miejski im. Józefa Strusia, Poznań, Poland https://orcid.org/0009-0009-7623-3007
Katarzyna Pinkowska Medical Center HCP, Poznań, Poland https://orcid.org/0009-0005-5048-0393
Weronika Nawrocka Szpital Specjalistyczny im. Stefana Żeromskiego SP ZOZ, Kraków, Poland https://orcid.org/0009-0000-3917-1884
Zuzanna Korbel Medical Center HCP, Poznań, Poland https://orcid.org/0009-0009-9863-1663
Mikołaj Jaszowski Szpital Uniwersytecki nr 2 im. dr. Jana Biziela, Bydgoszcz, Poland https://orcid.org/0009-0008-1433-6425
Inez Michalska Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland https://orcid.org/0009-0009-0116-0405
Agnieszka Dąbrowska Szpital Wojewódzki w Poznaniu, Poznań, Poland https://orcid.org/0009-0006-6517-3406
Patrycja Pietraszkiewicz Poznan University of Medical Sciences, Poznań, Poland https://orcid.org/0009-0007-4371-6999
Paula Żak Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland https://orcid.org/0009-0001-1251-432X
Filip Glista Poznan University of Medical Sciences, Poznań, Poland https://orcid.org/0000-0002-4456-6095

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5673

Keywords:

Proton Pump Inhibitors, Overprescription, Deprescribing, Dysbiosis, Adverse Drug Events, Clinical Decision Support, Artificial Intelligence

Abstract

Background. Proton pump inhibitors (PPIs) are effective medications widely used to manage acid-related disorders. However, their perceived safety has led to a global trend of overprescription. Therapy is often initiated during hospital stays for stress ulcer prophylaxis and continued indefinitely in primary care without a clear medical indication.

Aim. This narrative review aims to examine the clinical predictors and causes of PPI overuse, explore the medical consequences of long-term acid suppression, and discuss evidence-based strategies to promote rational use in clinical practice.

Material and Methods. The literature for this narrative review was selected from PubMed-indexed publications published between 2010 and 2026. ACG and AGA clinical guidelines, systematic reviews, and observational studies were analyzed to describe the predictors of PPI overuse, its medical consequences and evidence-based strategies for deprescribing.

Results. PPI overuse is primarily driven by prescribing inertia. Patient education significantly improves the success of dose reduction. While clinical decision support systems effectively reduce the initiation of inappropriate therapy, clinician acceptance of deprescribing alerts remains low compared to initiation prompts. In contrast, multidisciplinary models integrating artificial intelligence with pharmacist oversight achieve high rates of rational prescribing.

Conclusions. Given the massive global economic burden, PPI optimization requires a synergy of digital tools, patient education, and pharmacist-led oversight. This integrated strategy is essential for ensuring systemic sustainability and long-term medication safety.

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