Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

HSR Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Proton pump inhibitor discontinuation in long-term care.

Linsky A, Hermos JA, Lawler EV, Rudolph JL. Proton pump inhibitor discontinuation in long-term care. Journal of the American Geriatrics Society. 2011 Sep 1; 59(9):1658-64.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions


OBJECTIVES: To determine factors associated with proton pump inhibitor (PPI) discontinuation in long-term care. DESIGN: Retrospective cohort analysis. SETTING: Veterans Affairs (VA) long-term care facilities. PARTICIPANTS: Veterans admitted for nonhospice care in 2005 with a length of stay of 7 days or more who were prescribed a PPI within 7 days of admission (N = 10,371). MEASUREMENTS: Prescribed medications and comorbidities were determined from VA pharmacy and administrative databases and functional status from Minimum Data Set records. Associations between participant characteristics and PPI discontinuation were determined using Cox proportional hazard ratios (HRs), censoring at death, discharge, or 180 days after admission. RESULTS: Participants were predominantly male (97%) and had a median age of 73 (interquartile range 60-81). There were 2,749 (27%) PPI discontinuations; 43% of these occurred within 28 days of admission. Hospitalizations (HR = 1.22, 95% confidence interval (CI) = 1.01-1.46), preadmission PPI use (HR = 1.35, 95% CI = 1.16-1.56), and lowest functional status (HR = 1.22, 95% CI = 1.03-1.45) were associated with early PPI discontinuation in adjusted models. Participants with gastric acid-related disease (HR = 0.53, 95% CI 0.46-0.61), diabetes mellitus (HR = 0.82, 95% CI 0.72-0.94), and those who were prescribed six or more medications (6-7 medications, HR = 0.78, 95% CI = 0.66-0.92; 8-10 medications, HR = 0.64, 95% CI = 0.54-0.76; = 11 medications 0.51, 95% CI = 0.42-0.62) were less likely to have early discontinuation. No PPI discontinuer had PPIs resumed during the study, and few (9%) had histamine-2 receptor antagonist substitutions. CONCLUSION: Although there may be clinical uncertainty regarding PPI discontinuation, more than one-quarter of participants prescribed a PPI upon admission to long-term care had it discontinued within 180 days. Targeting individuals prescribed PPIs for medication appropriateness review may reduce prescribing of potentially nonindicated medications.

Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.