A 2018 study published in Clinical Gastroenterology and Hepatology, “Lack of association between proton pump inhibitor use and cognitive decline,” found no association between PPI use and cognitive decline in analyzing data from two large population-based studies in Denmark. While this data is reassuring, clinicians should continue to anticipate questions from their patients about the risks associated with PPI therapy.
- Reassure patients that you prescribed a PPI for a clear-cut indication, in the lowest possible dose, and for an appropriate period of time (lowest dose, shortest time). This advice echoes that offered by AGA and ABIM in the Choosing Wisely campaign.
- Educate patients not to ask “what side effects do PPIs have?” but rather “is it really indicated?” Reassure patients that, when PPIs are indicated, benefits outweigh risks.
- Keep conversation channels open with patients. When patients require long-term use of PPIs, the medication should not be stopped without a discussion with you about the risks and benefits.
- Recommend that patients also consider life-style modifications that may reduce or eliminate the need for PPIs for long-term use.