Educational visit

Starting, stepping down and stopping medicines

Discusses QUM principles around stopping medicines, with proton pump inhibitors (PPIs) for gastro-oesophageal reflux disease (GORD) used to illustrate when to review and how to step down or stop therapy safely and effectively.

  • End: 25 September 2018
  • Cost: free

A6C0E2A9D6B845D8 C3C9A1E90697 Stepping
 

CPD Points

PIP QPI

 

About

Knowing when and how to step down or stop medicines safely and effectively is a key quality use of medicines (QUM) consideration.

This educational visiting program uses proton pump inhibitors (PPIs) for GORD, as one of the most commonly prescribed, familiar medicines in general practice, to illustrate in detail what to consider at initiation, when to review, and when it’s appropriate to step down or stop.

Educational visits are available as:

  • One-on-one tailored discussions for GPs (30 minutes)
    We also offer our one-on-one visits via Skype (‘virtual visits’), so that GPs who find it difficult to schedule an in-practice visit can still benefit from our visiting program.
  • Small group meetings for up to 10 health professionals – GPs, practice nurses and pharmacists (1 hour)
 

Learning outcomes

One-on-one discussion

  • Distinguish between what is GORD or not when patients present with reflux symptoms.
  • Develop a plan for patients with GORD starting a PPI that considers lifestyle modifications and stepping down or stopping of PPI at review.
  • Discuss stepping down or stopping PPIs in GORD patients with adequately controlled symptoms.
  • Explain the balance of benefits and risks of ongoing PPI treatment for GORD.

Small group meeting

  • Review patient clinical presentation, medicines and lifestyle to establish a valid indication before prescribing PPIs.
  • Develop a plan for patients with GORD starting a PPI that considers lifestyle modifications and stepping down of PPI at 4–8 weeks review.
  • Review patients on long-term PPIs to confirm valid indication and balance long-term risks with benefits before prescribing ongoing PPI treatment.
  • Discuss stepping down or stopping PPIs in GORD patients with adequately controlled symptoms.
  • Discuss systems in your practice and prioritise areas for improvement in the management of patients prescribed PPIs for the management of GORD.