Information technology to reduce the irrational use of Proton Pump inhibitors – Narrative review




Proton pump inhibitors; Medical education; Gastroenterology; Internship and residency.


Introduction: Proton pump inhibitors (PPIs) were clinically introduced in 1989 and proved to be effective for the treatment of a wide range of conditions attributable to gastric acid. Over time, they became victims of their own success, being prescribed in excess, in high doses and for longer periods than indicated. On the other hand, information technology (IT) began to be used to assist the learning process, playing an increasingly important role in medical education. Objective: Since IT is such a versatile method of use within the field of medicine and health education, would this resource be able to reduce, through information and education of doctors and patients, the indiscriminate use of IBPS? Method: We performed a narrative review, using MEDLINE, PubMed, SciELO, LILACS, SCOPUS and Google Scholar databases to extract articles. We searched the literature of recent years, with DeCS/MeSH terms used in the search for “proton pump inhibitor”, “medical education”, “gastroenterology” and “boarding school and residency”, in addition to terms such as “prescription”, “ulcer”, “free open access medical education”, “FOAM”, FOAMed”, “information technology”, “medical apps”, “applications”, “proton pump inhibitors”. Result: After extensive research, articles with different educational tools were found, but only two (PINCER and FORTA-EPI) used IT for a more rational prescription of medications. Conclusion: There was a scarcity of publications relating information technology and gastroenterology, as well as the use of proton pump inhibitors, indicating the need for studies that actually prove that there would be a reduction in prescriptions without indication of IBPS and validation of applications for this purpose. In view of the above, it was possible to conclude that feedback interventions and educational guidelines have the possibility of positively guiding medical conduct in clinical practice. In this way, we propose the development of an application to facilitate this difficult area of intervention.


Ahmed, I., Ahmad, N. S., Ali, S., Ali, S., George, A., Danish, H. S., . . . King, D. (2018). Medication adherence apps: review and content analysis. JMIR mHealth and uHealth, 6(3), e6432.

Alencar, J. B. d., Araújo, R. L., Barroso, E. M. d., Silva, P. G. d. B., Garrido, R. J., Rocha, P. H. M. d., & Rocha, E. P. C. (2020). Development and Validation of a Smartphone Application for Orthopedic Residency Education. Revista Brasileira de Educação Médica, 44.

Avery, A. J., Rodgers, S., Cantrill, J. A., Armstrong, S., Cresswell, K., Eden, M., . . . Sheikh, A. (2012). A pharmacist-led information technology intervention for medication errors (PINCER): a multicentre, cluster randomised, controlled trial and cost-effectiveness analysis. Lancet, 379(9823), 1310-1319.

Boster, J., Lowry, L. E., Bezzant, M. L., Kuiper, B., & Surry, L. (2020). Reducing the inappropriate use of proton pump inhibitors in an internal medicine residency clinic. Cureus, 12(1).

de Paula Pessoa, F. S. R., Leite, A. B., Maia, M. M., & Nunes, J. F. (2021). TRAT-C 2019: ESQUEMAS DE TRATAMENTO DA HEPATITE C NA PALMA DA MÃO. Cadernos ESP-Revista Científica da Escola de Saúde Pública do Ceará, 15(1), 44-48.

Gordon, W. J., Landman, A., Zhang, H., & Bates, D. W. (2020). Beyond validation: getting health apps into clinical practice. NPJ Digit Med, 3, 14.

Kuemmerle, J. F. (2012). Effective use of technology in gastroenterology training. Gastroenterology, 143(4), 881-884.

Lazaridis, L.-D., Rizos, E., Bounou, L., Theodorou-Kanakari, A., Kalousios, S., Mavroeidi, E.-A., . . . Miltiadou, K. (2021). An educational intervention to optimize use of proton pump inhibitors in a Greek university hospital. Annals of Gastroenterology, 34(6), 781.

Machado Júnior, P. A. B., Ziliotto, R. D., Ferreira, A. P. V. N., Buson, T. M., Couto, C. M. d., & Pissaia Junior, A. (2020). Uso do Stroop EncephalApp para o screening de encefalopatia hepática mínima em pacientes cirróticos no sul do Brasil. Arquivos de Gastroenterologia, 57, 399-403.

Madanick, R. D. (2015). Education Becomes Social: The Intersection of Social Media and Medical Education. Gastroenterology, 149(4), 844-847.

Ni, X., Lin, M., Li, J., Zeng, L., Li, W., Huang, L., . . . Zhang, L. (2021). Development of an evaluation indicator system for the rational use of proton pump inhibitors in pediatric intensive care units: An application of Delphi method. Medicine (Baltimore), 100(24), e26327.

Nilsson, G., Hjemdahl, P., Hässler, A., Vitols, S., Wallén, N. H., & Krakau, I. (2001). Feedback on prescribing rate combined with problem-oriented pharmacotherapy education as a model to improve prescribing behaviour among general practitioners. Eur J Clin Pharmacol, 56(11), 843-848.

O'Connor, J. B., & Johanson, J. F. (2000). Use of the Web for medical information by a gastroenterology clinic population. Jama, 284(15), 1962-1964.

Rabenberg, A., Schulte, T., Hildebrandt, H., & Wehling, M. (2019). The FORTA (Fit fOR The Aged)-EPI (Epidemiological) Algorithm: Application of an Information Technology Tool for the Epidemiological Assessment of Drug Treatment in Older People. Drugs Aging, 36(10), 969-978.

Reeve, E. (2020). Deprescribing tools: a review of the types of tools available to aid deprescribing in clinical practice. Journal of Pharmacy Practice and Research, 50(1), 98-107.

Scarpignato, C., Gatta, L., Zullo, A., Blandizzi, C., Group, S.-A.-F., & Italian Society of Pharmacology, t. I. A. o. H. G. a. t. I. F. o. G. P. (2016). Effective and safe proton pump inhibitor therapy in acid-related diseases - A position paper addressing benefits and potential harms of acid suppression. In BMC Med (Vol. 14, pp. 179).

Schnoll-Sussman, F., Niec, R., & Katz, P. O. (2020). Proton Pump Inhibitors: The Good, Bad, and Ugly. Gastrointest Endosc Clin N Am, 30(2), 239-251.

Shroff, H., Aby, E., Patel, P., Winters, A. C., Vogel, A. S., & Mikolajczyk, A. (2021). LIVER FELLOW NETWORK: A SURVEY OF THE IMPACT OF A NOVEL ONLINE MEDICAL EDUCATION TOOL. Gastroenterology, S-399-S-400.

Strand, D. S., Kim, D., & Peura, D. A. (2017). 25 Years of Proton Pump Inhibitors: A Comprehensive Review. Gut Liver, 11(1), 27-37.

Targownik, L. E., Fisher, D. A., & Saini, S. D. (2022). AGA clinical practice update on De-prescribing of proton pump inhibitors: expert review. Gastroenterology.

Wu, J., Dickinson, S., Elgebaly, Z., Blogg, S., Heaney, A., Soo, Y., . . . Weekes, L. (2020). Impact of NPS MedicineWise general practitioner education programs and Choosing Wisely Australia recommendations on prescribing of proton pump inhibitors in Australia. BMC family practice, 21(1), 1-8.

Yadlapati, R., & Kahrilas, P. J. (2017). When is proton pump inhibitor use appropriate? In BMC Med (Vol. 15, pp. 36).



How to Cite

CAVALCANTE, R. M. .; AUGUSTO, K. L. .; KUBRUSLY, M. Information technology to reduce the irrational use of Proton Pump inhibitors – Narrative review. Research, Society and Development, [S. l.], v. 12, n. 2, p. e7512239815, 2023. DOI: 10.33448/rsd-v12i2.39815. Disponível em: Acesso em: 7 jun. 2023.



Review Article