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- Page navigation anchor for RE: More deprescribing guideline knowledge mobilization toolsRE: More deprescribing guideline knowledge mobilization tools
Hello readers. Since publication of the evidence-based PPI deprescribing guideline, the Bruyère Deprescribing Guidelines Research Team has developed a number of tools (in addition to the algorithm and patient pamphlet available in CFPLUS) to support guideline use:
• An infographic that can be used as a poster or handout to encourage patients to talk to their health care providers about the potential for PPI deprescribing.
https://deprescribing.org/wp-content/uploads/2018/08/Deprescribing-focus...• A whiteboard video on how to use the PPI deprescribing algorithm.
https://www.youtube.com/watch?v=EH2vEGJYqVI&t=• Mobile app through IAM Medical Guidelines to facilitate point of care guideline use.
https://deprescribing.org/news/evaluation-of-a-deprescribing-guideline-m...When using the app, please complete our in-app survey to help us understand the application and usefulness of this deprescribing knowledge.
Competing Interests: None declared. - Page navigation anchor for RE: Lack of a standart approach to GERD and elimination diet is a key for overprescribing PPIRE: Lack of a standart approach to GERD and elimination diet is a key for overprescribing PPI
I read the article titled “Deprescribing proton pump inhibitors” with a great interest. As a practicing endoscopist I advocate for avoiding ongoing re-prescribing of PPIs for patients with GERD.
The authors have successfully demonstrated evidence against ongoing use of PPIs in GERD however they have not provided sufficient tools for primary care practitioner to assist patients with managing symptoms while not on PPI. I often see in my practice that when patients are not given effective education for GERD and elimination diets they become victims of different health marketing trends that lead to frustration due to variety of diet failure. This leads them to return to practitioner to request a PPI. Although there are many studies on dietary intervention in GERD, however there is still no standard approach to GERD diet. When studies such as Kaltenbach T. et al (6), that was mentioned here, and other (1-2) compare effect of GERD diet on GERD symptoms, they often compare similar but not same approaches thus not able to draw a clear conclusion on effectiveness of the GERD diet. This leads to lack of practical tools for practitioner to implement in patients’ care.
In the article the authors also suggest that when PPI and diet approach fail that a practitioner should ensure to test for and treat H.pylori. I would disagree with this recommendation as an evidence of H.pylori contributing to GERD is equivocal and even a reverse relationship has been demonstrated in se...
Show MoreCompeting Interests: None declared.