By: Ebey P. Soman<\/p>\n
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Proton pump inhibitors (PPIs) are medications commonly prescribed to treat heartburn, acid reflux disease, and ulcers. \u00a0Almost a vast majority of patients in the United States seem to be taking a PPI, either as a prescription or from over-the-counter (OTC).\u00a0 Researchers recently discovered associations between the long-term use of PPIs and bone fractures. \u00a0Now, a new study published in the British Medical Journal (BMJ) revealed more condemning links to bone fractures in a prospective cohort study titled \u201cUse of proton pump inhibitors and risk of hip fracture in relation to dietary and lifestyle factors.\u201d<\/p>\n
The study used 79,899 women (aged between 30 and 55) enrolled in the Nurses\u2019 Health Study.\u00a0 The women provided six-month\u2019s worth of data on their use of PPIs and other risk factors. \u00a0The main monitoring outcome was the incidence of hip fractures in women taking PPIs compared to women who did not take PPIs, as well as women who smoked while taking PPIs. \u00a0The study showed that the risk of hip fractures in women taking long term PPIs was 2.02 events per 1000 person years, compared with 1.51 events per 1000 person years among women not taking any PPIs. \u00a0Women who used PPIs regularly for two years had a 35% increased risk of fractures, with longer usage continuing to increase that risk.<\/p>\n
The results in women who smoked or had a history of smoking were even more interesting. \u00a0The use of PPIs in this population resulted in a 50% increased risk of hip fracture compared with women who did not take the medication. \u00a0The study concluded, \u201cChronic use of PPIs is associated with increased risk of hip fracture, particularly among women with a history of smoking.\u201d<\/p>\n
Dr. John Stevenson, who sits on the medical advisory council of the British Menopause Society, stated that the study shows an association between PPI use and hip fractures, but is not significant enough to warrant a warning against use in patients needing such medications. \u00a0However, it is a clear indicator of the need to educate patients on appropriate ways to take PPIs and smoking cessation.<\/p>\n
Mr. Dan Greer, the Royal Pharmaceutical Society spokesperson on gastroenterology medicines, stated, \u201cthis study strengthens the current recommendations for PPI use, in that for the majority of patients with symptoms of indigestion, PPIs should only be used for short courses (one to two months), with repeat courses offered at the lowest dose that controls symptoms.\u201d<\/p>\n
Community pharmacists play a vital role in society as the bridge between the patient and the medical community. \u00a0Thus, this is an important opportunity for pharmacists to make headway into counseling patients on proper usage of certain OTC medications, such as PPIs. \u00a0It also raises the necessity to push smoking cessation programs and to offer information about making healthy choices to prevent future complications.<\/p>\n
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