使用酸抑制疗法(AST)是用于管理广谱的酸消化性病症的常用方法。组胺2型受体拮抗剂(H2RAs)和质子泵抑制剂(PPI)是常规临床实践中最广泛使用的AST。然而,PPI处方的指数激增,比如奥美拉唑,埃索美拉唑,泮托拉唑,近年来兰索拉唑及其相关的不良反应引起了人们对其不当和过度使用的关注,无论是在儿童和成人。为了解决这些问题,我们采用了三步改进的Delphi轮询流程,以建立最佳实践共识声明,从而合理使用抑酸剂.由13名医疗专业人员组成的多学科专家小组,包括胃肠病学家,肝病学家,儿科胃肠病学家,儿科医生,耳鼻喉科医师,心脏病学家,肾脏病学家,妇科医生和骨科医生为这一共识发展的合作进程做出了积极贡献。专家小组根据对科学文献和临床专业知识的全面审查,提出了21项共识声明,提供了关于酸抑制剂的一般使用和安全性的最佳实践要点。该小组还合作开发了PPI去处方算法。总之,这份共识文件为合理使用抑酸剂提供了循证建议和指导,并为取消PPI处方提供了蓝图.这份共识文件有助于帮助初级保健医生改善患者预后并最大程度地降低医疗保健成本。此外,它提高了患者的安全和减少不当使用。
■PrabhooRy,派UA,WadhwaA,etal.在儿童和成人中合理使用酸抑制剂的多学科共识:CONFOR。欧亚J肝胃肠病2024;14(1):99-119。
The use of acid suppression therapy (AST) is a common approach for managing a wide spectrum of acid peptic disorders. Histamine type 2-receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) are the most widely prescribed AST in routine clinical practice. However, an exponential surge in the prescriptions of PPIs, such as Omeprazole, Esomeprazole, Pantoprazole, Lansoprazole in recent years and their associated adverse effects have raised concern about their inappropriate and overuse, both in children and adults. To address these issues, a three-step modified Delphi polling process was employed to establish best practice
consensus statements for rationalizing the use of acid suppressants. A multidisciplinary expert panel of 13 health professionals across medical specialties, including gastroenterologists, hepatologists, pediatric gastroenterologists, pediatricians, otolaryngologists, cardiologists, nephrologists, gynecologist and orthopedists actively contributed to this collaborative process of consensus development. The expert panel proposed 21
consensus statements providing best practice points on the general use and safety of acid suppressants based on a comprehensive review of scientific literature and clinical expertise. The panel also collaboratively developed a PPI deprescribing algorithm. Altogether, this
consensus paper offers evidence-based recommendations and guidance for the rational use of acid suppressants with a blueprint for deprescribing PPIs. This
consensus paper contributes to aiding primary care practitioners in improving patient outcomes and minimizing healthcare costs. Additionally, it enhances patient safety and curtail inappropriate usage.
UNASSIGNED: Prabhoo RY, Pai UA, Wadhwa A, et al. Multidisciplinary
Consensus for Rationalizing the Use of Acid Suppressants in Children and Adults: CONFOR. Euroasian J Hepato-Gastroenterol 2024;14(1):99-119.