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Inappropriate use of proton pump inhibitors in clinical practice globally: a systematic review and meta-analysis
  1. Amit K Dutta1,
  2. Vishal Sharma2,
  3. Abhinav Jain3,
  4. Anshuman Elhence4,
  5. Manas K Panigrahi5,
  6. Srikant Mohta6,
  7. Richard Kirubakaran7,
  8. Mathew Philip8,
  9. Mahesh Goenka9,
  10. Shobna Bhatia10,
  11. Usha Dutta2,
  12. D Nageshwar Reddy11,
  13. Rakesh Kochhar12,
  14. Govind K Makharia4
  1. 1Gastroenterology, Christian Medical College and Hospital Vellore, Vellore, India
  2. 2Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  3. 3Gastroenterology, Gastro 1 Hospital, Ahmedabad, India
  4. 4Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
  5. 5Gastroenterology, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, India
  6. 6Department of Gastroenterology, Narayana Superspeciality Hospital, Kolkata, India
  7. 7Center of Biostatistics and Evidence Based Medicine, Vellore, India
  8. 8Lisie Hospital, Cochin, India
  9. 9Apollo Gleneagles Hospital, Kolkata, India
  10. 10Gastroenterology, National Institute of Medical Science, Jaipur, India
  11. 11Asian Institute of Gastroenterology, Hyderabad, India
  12. 12Gastroenterology, Paras Hospitals, Panchkula, Chandigarh, India
  1. Correspondence to Dr Amit K Dutta, Gastroenterology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India; akdutta1995{at}gmail.com

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We read with interest the population-based cohort studies by Abrahami et al on proton pump inhibitors (PPI) and the risk of gastric and colon cancers.1 2 PPI are used at all levels of healthcare and across different subspecialties for various indications.3 4 A recent systematic review on the global trends and practices of PPI recognised 28 million PPI users from 23 countries, suggesting that 23.4% of the adults were using PPI.5 Inappropriate use of PPI appears to be frequent, although there is a lack of compiled information on the prevalence of inappropriate overuse of PPI. Hence, we conducted a systematic review and meta-analysis on the inappropriate overuse of PPI globally.

The details of the methodology are described in the online supplemental file. The literature was searched from inception until 19 July 2023 (PubMed, Embase and Scopus) for studies that reported on the inappropriate overuse of PPI. Two investigators independently performed each step, from screening to study selection to data extraction and quality assessment. The pooled rates were calculated using a random intercept logistic regression model. The Preferred Reporting …

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  • Contributors AKD: concept, study design, data acquisition and interpretation, drafting the manuscript and approval of the manuscript. VS: study design, data acquisition, analysis and interpretation, drafting the manuscript and approval of the manuscript. AJ, AE, MKP, SM: data acquisition and interpretation, critical revision of the manuscript, and approval of the manuscript. RK: study design, data analysis and interpretation, critical revision of the manuscript and approval of the manuscript. MP, MG, SB, UD, DNR, RK: data interpretation, critical revision of the manuscript and approval of the manuscript. GKM: concept, study design, data interpretation, drafting the manuscript, critical revision and approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.