2026 年 52 巻 8 号 p. 569-577
Proton pump inhibitors (PPIs) are classified as potentially inappropriate medications for older adults. Indiscriminate long-term use of PPIs after symptom resolution (indiscriminate PPIs) may increase the risk of adverse events and healthcare costs, emphasizing the need for appropriate prescribing. However, indiscriminate PPIs are often prescribed, and the awareness of community pharmacists regarding this issue remains unclear. This study aimed to assess pharmacists perceptions of indiscriminate PPIs and identify barriers to resolving them. A self-administered questionnaire survey was administered to community pharmacists (N = 314). The survey included pharmacists’ experiences with dispensing and providing medication counseling for PPIs and their attitudes toward indiscriminate PPIs. Among the respondents, 70.8％ recognized the presence of indiscriminate PPIs, yet 92.3％ reported that they could not adequately address the issue. The most common intervention among the effective respondents (7.7％) was advising patients to discuss discontinuation with their physicians on their next visit (41.2％). In contrast, those unable to intervene mainly inquired about the patient’s situation (36.8％). The primary barriers were “insufficient information from the prescribing physician, such as the rationale for the prescription” (83.3％) and “patients’ resistance to reducing medication” (79.4％). Although many pharmacists recognized indiscriminate PPIs and the need for deprescribing, the majority faced significant barriers to sufficient action. To overcome these barriers, strengthening communication with prescribing physicians regarding diagnoses and treatment intentions is suggested as essential to facilitate appropriate deprescribing. Furthermore, it is concluded that proactive and tailored medication counseling by pharmacists may help motivate patients to accept medication reduction.
