A Pharmacist-Led Medication Use Evaluation of Proton-Pump Inhibitors

Objective: To determine whether patients maintain symptom control after discontinuation of PPI (proton-pump inhibitor) therapy through intervention of a pharmacist-led medication utilization program and determine annual clinic cost-savings per prescription. Design: The study was conducted as a prospective, medication use evaluation. Using an electronic medical record system at a clinic, reports generated all patients receiving PPI therapy from January 2013-June 2015. Patients were encouraged to participate in a PPI discontinuation trial through a pharmacist-led educational session. Participants were followed-up three months post enrollment to assess their quality of life through a survey assessing severity and frequency of symptoms. Participants unable to maintain symptom control after the intervention were referred back to their primary care physician for further evaluation. Results: Of one hundred participants, 25% (n = 25) were able to discontinue the use of PPI by lifestyle modifications, 43% (n = 43) refused to discontinue PPI therapy and lifestyle changes due to the severity of their symptoms, 17% (n = 17) switched to over-the-counter H2 receptor antagonist daily to control their symptoms, 9% (n = 9) used PPIs only as needed, and 6% (n = 6) of participants were dropped from the study after three failed communication attempts. The clinic saved approximately $11 thousand annually for every one prescription of PPI's. Conclusions: Discontinuation of PPI or step-down therapy was possible for patients with mild-moderate GERD (Gastroesophageal Reflux Disease) symptoms when mediated by pharmacist counseling and follow-up. Also, the annual PPI expenditure at this clinic will decrease due to participant's discontinuation of therapy.