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Table 2 Summary of themes and subthemes

From: Discussing proton pump inhibitor deprescribing: the views of Danish GPs and older patients

Theme

Subthemes

Summary

Reasons PPI deprescribing comes up

Concern about medication burden in general

PPI deprescribing often came up as part of a strategy of reducing the overall number of medication patients were taking – this concern could be brought up by patients or GPs.

Consultations for other problems

PPI deprescribing was often tagged onto consultations for other problems rather than a reason for the consultation.

Asking about PPI deprescribing specifically

GPs felt patients rarely brought up deprescribing of PPIs specifically; however, patients stated they might bring it up if they were worried about adverse effects.

Considering PPI deprescribing

Low-hanging fruit

GPs stated that PPIs were one of their first targets when considering deprescribing of medications.

Searching for an indication

GPs needed to assess whether deprescribing was clinically appropriate before getting into a discussion; this could include gathering information from the patient or chart.

Discussion topics

Explaining the rationale for deprescribing

GPs stated they would talk to patients about why deprescribing was an option for them, and patients reported wanting to understand why a PPI could be deprescribed.

Planning and follow-up

GPs stated they would talk to patients about rebound symptoms and how to manage them; patients stated they wanted to know what to do if their symptoms came back.

Incorporating patient preferences into PPI deprescribing decisions

GPs acknowledged that patients have different preferences related to PPI treatment; some GPs would actively discuss this and incorporate preferences into decisions whereas other GPs would not routinely talk to patients about their preferences. Patients had different views on how much they would like to discuss preferences and be involved in decisions.

  1. Abbreviations: GP general practitioner, PPI proton pump inhibitor