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Activity description

126648 - Starting, stePPIng down and stoPPIng medicines - Educational Visit - 2018 - 2019

National Prescribing Service Ltd

Supporting best practice in PPI use for managing patients with GORD as an example to demonstrate quality use of medicine (QUM) principles. These principles include starting medicines only when necessary, and stepping down or stopping medicines when no longer required.

Relevance to General Practice

Gastro-oesophageal reflux is common, with 15-20% of Australians experiencing heartburn at least once a week. Gastro-oesophageal reflux disease (GORD) occurs when patients experience frequent or severe reflux symptoms, and is managed mainly through a combination of lifestyle changes and medicines.

Current guidelines recommend starting GORD treatment with short-term standard-dose PPI (4-8 weeks), followed by regular review to step-down the dose or stop the medicine. However evidence suggests that in Australia, most PPIs are being used in the long term, with overuse in inpatient and outpatient settings, often without appropriate indication.

While PPIs are generally safe, there is some emerging evidence of possible rare but serious adverse events that also need to be considered. This educational visit will address the holistic management of GORD, specifically addressing the recommended use of PPIs, providing guidance on starting, stepping down and stopping treatment.

Learning outcomes

  1. Review patient clinical presentation, medicines and lifestyle to establish a valid indication before prescribing PPIs.
  2. Develop a plan for patients with GORD starting a PPI that considers lifestyle modifications and stepping down or stopping of PPI at review.
  3. Discuss stepping down or stopping PPIs in GORD patients who have adequately controlled symptoms.
  4. Explain the benefits and risks of ongoing PPI treatment for GORD.

Domains of General Practice

D1. Communication skills and the patient-doctor relationship
  • Communication is clear, respectful, empathic and appropriate to the person and their sociocultural context

D2. Applied professional knowledge and skills
  • Rational prescribing and medication monitoring is undertaken

D3. Population health and the context of general practice
  • Current and emerging public health risks are effectively managed

D4. Professional and ethical role
  • Professional knowledge and skills are reviewed and developed

D5. Organisational and legal dimensions
  • Shared decision making and informed consent are explained and obtained

Curriculum Contextual Units

  • Adult health

Session summary


Tuesday 1 May 2018 12:00am - Friday 31 May 2019 12:00am

This activity is readily available at any time


Various GP Practices


Face to face




All attendees welcome

Target Audience


For more information contact...

Customer Service
T: 0282178700