Considerations for the use of proton-pump inhibitors in older adults

Alicia R Desilets, Nicole J Asal, Kaelen C Dunican
Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists 2012, 27 (2): 114-20

OBJECTIVE: To investigate current concerns regarding the use of proton-pump inhibitors (PPIs) in older adults.

DATA SOURCES: A literature search was conducted in MEDLINE (1948 to April week 3 2011) to identify relevant publications. Key words searched included proton-pump inhibitor, safety, adverse events, elderly, and older adults. Additional data sources were obtained through a bibliographic review of selected articles.

DATA SELECTION: Relevant studies conducted in older adults published in English that examined risks associated with the use of PPIs were included in this review.

DATA SYNTHESIS: The older adult population in the United States is growing at an astounding rate. With the increase in age, there are many factors that make the elderly susceptible to acid-related gastrointestinal disorders that require treatment with PPIs. However, PPI use in the elderly has been shown to lead to a number of health concerns. Recent data have shown that PPI use is associated with an increased risk of fractures, Clostridium difficile infection, community-acquired pneumonia, vitamin and mineral deficiencies, and drug interactions. These concerns will be further investigated and weighed against the benefits of PPI use in this population.

CONCLUSIONS: Patient-specific characteristics must be taken into consideration when recommending and/or prescribing PPIs to older adults.

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