Cochrane · systematic review · CD011969
Deprescribing versus continuation of chronic proton pump inhibitor use in adults
Boghossian, TA, Rashid, FJ, Thompson, W, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
GutAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
6
No studies
1
Included studies
NR
No studies 1 · 14.3%Ungraded 0 · 0%Very low 3 · 42.9%Low 2 · 28.6%Moderate 1 · 14.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
On‐demand deprescribing compared to continued use for people with moderate GERD and mild esophagitis
Population: people with moderate GERD and mild esophagitis, mean age 48 to 57 years
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Lack of symptom control On‐demand deprescribing vs continued use | RR 1.71 [1.31, 2.21] | 5 studies · 1653 participants | Low Downgraded: risk of bias, imprecision |
Pill use (pills/week) On‐demand deprescribing vs continued use | no estimate extracted | 3 studies · 1152 participants | Moderate Downgraded: risk of bias |
Cost/resource use On‐demand deprescribing vs continued use | no estimate extracted | NR | No studies |
Adverse drug withdrawal events ‐ esophagitis (endoscopic findings) On‐demand deprescribing vs continued use | RR 30.59 [1.84, 508.91] | 1 study · 598 participants | Low Downgraded: risk of bias, imprecision |
Participant satisfaction On‐demand deprescribing vs continued use | RR 1.82 [1.26, 2.65] | 5 studies · 1653 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Abrupt discontinuation deprescribing compared to continued use for people with mild‐to‐moderate esophagitis
Population: people with mild to moderate esophagitis, symptomatic, aged > 18 years (mean age 73 years)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Lack of symptom control Abrupt discontinuation deprescribing vs continued use | RR 3.02 [1.74, 5.24] | 1 study · 105 participants | Very low Downgraded: risk of bias, imprecision |
Adverse drug withdrawal events ‐ relapse (endoscopic findings) Abrupt discontinuation deprescribing vs continued use | RR 3.41 [1.91, 6.09] | 1 study · 105 participants | Very low Downgraded: risk of bias, imprecision |