Who has the guts to deprescribe proton pump inhibitors? A pharmacist‐led intervention in a long‐term care facility setting

OBJECTIVE: Long‐term use of proton pump inhibitors (PPIs) has been associated with an increased risk of harm. There are few studies evaluating pharmacist‐led PPI deprescribing interventions within a long‐term care facility setting. The aim of this study was to describe the changes and influencing factors seen with a pharmacist‐led PPI deprescribing intervention in two Fraser Health Authority long‐term care facilities in British Columbia. METHODS: This 4‐month intervention involved lists of residents who had active PPI orders being handed out to physicians from two facilities. The pharmacist conducted weekly reviews of residents from Facility 1 and offered deprescribing recommendations. The number and methods of PPI deprescribing orders per facility were determined after the intervention. RESULTS: Out of 58 residents from the two facilities, 30 (62.5%) had a deprescribing order. Facility 1 had 83.3% (20/24) of residents with a PPI deprescribing order, in contrast to 41.7% (10/24) from Facility 2. Overall, 80.0% of residents had successfully completed PPI deprescribing orders by the end of the study period. CONCLUSION: Clinical pharmacist intervention may increase the rate of initiation in PPI deprescribing orders within a long‐term care facility setting. Factors that influence success include intervention timing, active collaboration, having residents under direct care, and clear documentation of PPI indications.