Proton pump inhibitors (PPIs) are the mainstay of treatment for acid-related diseases in the upper gastrointestinal tract. In Australia in 2017–18, the PPIs esomeprazole and pantoprazole were the third and fourth most-prescribed medicines by volume on the Pharmaceutical Benefits Scheme, after two statins.1

Learning objectives

After reading this article, pharmacists should be able to:

  • Identify the recommendations for proton pump inhibitor (PPI) treatment of gastro-oesophageal reflux disease (GORD), including deprescribing
  • Recognise the harms associated with long-term use of PPIs
  • Discuss the role of the pharmacist in supporting patients with GORD, including provision of advice on lifestyle, medicines, and stepping-down treatment.

Competencies (2016) addressed: 1.1, 1.3, 1.6, 2.3, 2.4, 3.1, 3.5, 3.6.

Accreditation number: CAP1906B.

Gastro-oesophageal reflux disease (GORD) is a common presenting condition in Australian primary care. A 2012–14 analysis found that 65% of PPIs ordered by general practitioners were for GORD.2

Although GORD is generally an intermittent disease, many patients continue on PPI treatment long term. This leads to unnecessary personal and healthcare costs to treat mild, intermittent symptoms.3 Even with a diagnosis of GORD, managing aggravating factors can help relieve symptoms.

Pharmacists can encourage patients to make dietary and lifestyle changes, and assist them identify medicines that exacerbate symptoms.

Test your knowledge on this article’s assessment questions here to earn up to 1.5 Group 2 CPD credits.