Background: Proton pump inhibitors (PPI) are generally well tolerated. However, PPI treatment for more than eight weeks is rarely indicated and increases the risk of adverse events. In patients of a geriatric hospital, we examined the feasibility of deprescribing PPIs when longer than 8 weeks use was inappropriate.

Methods: In a cross-sectional survey, all patients who were receiving a PPI were re-examined, in pondering indication for ongoing PPI treatment. Those inadequately receiving PPI were candidates for deprescribing. At study conclusion 80 days later the patient files were reviewed for PPI use, gastrointestinal symptoms, new or aggravated anemia.

Results: Out of 80 patients in both departments (median age 78 years, median frailty score 7 out of 9 points), 63 received a PPI. Continuation of PPI treatment was inappropriate according to guidelines in 26 patients. Deprescribing the PPI was accepted by patients or nearest kin in 20 patients. On study conclusion, eighty days after initiating deprescribing, 10 patients were off PPI, 2 were receiving minimal dose PPI, 6 had restarted PPI. Represcribing was requested upon occurrence of dyspepsia or an ambiguous abdominal discomfort.

Conclusion: Among severely frail residents of the geriatric hospital, deprescribing PPIs was feasible. However, resuming the PPI was common, like the high rates of restarting PPI treatment reported in the literature. We advocate that deprescribing should take into consideration the patient’s life expectancy, ability to communicate symptoms, bleeding risk, as well as experts’ opinion that the main value in deprescribing PPI treatment is a reduced pill burden and cost.