Digital Proton Pump Inhibitor Prescribing Education at The Point of Prescription: A Real-World Study in a Primary Care Setting
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Publisher
Sage
Abstract
Background: Proton pump inhibitors (PPIs) are frequently prescribed in primary care, often for durations that exceed
guideline recommendations. We evaluated whether a digital point-of-prescription educational intervention based on the
updated March 2023 Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS)
GERD guideline could influence the prescribing patterns of primary care physicians (PCPs).
Methods: We conducted a 12-month retrospective cohort study using anonymized prescription data from PCPs in Germany.
Intervention physicians (n = 886) received EMR-integrated pop-up messages with guideline-based recommendations and
optional links to further content on the “Praxiswelt” (Practice World) educational platform. A matched control group
(n = 886) received no messages. Physician engagement (click rates), PPI prescription volume, pack size, and use of ICD-10
diagnosis codes were compared pre- (Q2-Q4 2022) and post-guideline (Q2-Q4 2023). Analyses were descriptive.
Results: A total of 31 629 pop-ups were displayed (mean 37.7 per physician); of these, 32.7% generated positive
interactions, 0.4% negative, and 66.9% no interaction. PPI prescription volume changed by −2.8% in the intervention group
versus +0.7% in controls. Most prescriptions exceeded the recommended 8-week duration (91%-100%). ICD-10 coding
rates remained low (missing codes: intervention 75.2% pre-guideline vs 76.7% post-guideline; controls 90.0% vs 88.1%).
Conclusion: Digital pop-up education at the point of prescription produced only minimal changes in prescribing
volume and coding behavior. The limited effect may reflect alert fatigue, passive content, and single-channel delivery.
Future strategies should combine point-of-prescription alerts with interactive decision support, audit and feedback, and
system-level changes to improve both adherence and documentation.
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Except where otherwise noted, this item's license is described as Attribution-NonCommercial 4.0 International