Prescribing, deprescribing and potential adverse effects of proton pump inhibitors in older patients with multimorbidity: an observational study

Department of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O’Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women’s College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands

Department of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O’Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women’s College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands

Department of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O’Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women’s College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands

Department of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O’Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women’s College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands

Department of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O’Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women’s College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands

Department of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O’Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women’s College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands

Department of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O’Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women’s College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands

Department of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O’Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women’s College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands

Department of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O’Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women’s College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands

Department of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O’Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women’s College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands

Department of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O’Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women’s College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands

Department of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O’Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women’s College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands

Department of General Internal Medicine (Aubert, Blum, Aujesky, Rodondi), Inselspital, Bern University Hospital, University of Bern; Institute of Primary Health Care (Aubert, Blum, Gastens, Rodondi), University of Bern, Bern, Switzerland; Clinical Pharmacy Research Group (Dalleur), Université Catholique de Louvain, Louvain Drug Research Institute; Pharmacy Department (Dalleur, Vaillant), Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Department of Medicine (Geriatrics) (Jennings, O’Mahony), Cork University Hospital, University College Cork, Cork, Ireland; Women’s College Hospital Research Institute (Thompson), Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Thompson), Faculty of Medicine, University of British Columbia, Vancouver, BC; Departments of Internal Medicine and Pharmacology-Toxicology (Kool, Kramers), Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, the Netherlands; Department of Geriatric Medicine and Expertise Centre Pharmacotherapy in Old Persons (Knol), University Medical Centre Utrecht, University of Utrecht, the Netherlands