Impact of a national Smarter Medicine guideline on outpatient proton-pump inhibitor prescription in Switzerland: a nationwide interrupted time-series analysis

Background

Proton-pump inhibitors (PPI) are a key treatment for gastro-oesophageal disease, but their frequent overprescription leads to potential adverse effects and an economic burden. In this retrospective study, we investigated the effect of a Smarter Medicine guideline published in May 2014 by the Swiss Society of General Internal Medicine, which recommended that general practitioners should avoid “long-term treatment of gastrointestinal symptoms with proton-pump inhibitors without titrating to the lowest effective dose needed”.