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PPI deprescribing — GPhC CRA MCQ

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EasyGI TherapeuticsPPI deprescribingGPhC CRA

A 58-year-old man presents a repeat prescription for lansoprazole 30 mg daily. He has been taking this for 4 years for dyspepsia with no recent endoscopy. What is the most appropriate pharmacist intervention?

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Correct answer: E — Recommend a structured PPI step-down or discontinuation trial with the GP

Long-term PPI use is associated with risks including hypomagnesaemia, Clostridium difficile infection, osteoporotic fractures, and vitamin B12 deficiency. NICE recommends periodic review of PPI use and attempting step-down or discontinuation in patients without a clear ongoing indication (such as Barrett's oesophagus or long-term NSAID/antiplatelet use). The pharmacist should discuss with the GP about a structured step-down plan.

Reference: NICE CKS GORD; BNF PPIs