title: Use of proton pump inhibitors among older Australians: national quality improvement programmes have led to sustained practice change.
abstract: OBJECTIVE
  To evaluate the impact of national multifaceted initiatives to improve use of proton pump inhibitors (PPIs) on the use of PPIs among older Australians.
  
  
  METHODS
  Interrupted time series analysis using administrative health claims data from the Australian Government Department of Veterans' Affairs (DVA).
  
  
  METHODS
  Australia.
  
  
  METHODS
  All veterans and dependents who received PPIs between January 2003 and December 2013.
  
  
  METHODS
  National, multifaceted interventions to improve PPI use were conducted by the Australian Government Department of Veterans' Affairs Veterans' MATES programme and Australia's NPS MedicineWise in April 2004, June 2006, May 2009 and August 2012.
  
  
  METHODS
  Trends in monthly rate of use of any PPI among the veteran population, and the monthly rate of use of low strength PPIs among all veterans dispensed a PPI.
  
  
  RESULTS
  Interventions in 2004, 2006, 2009 and 2012 slowed the rate of increase in PPI use significantly, with the 2012 intervention resulting in a sustained 0.04% decrease in PPI use each month. The combined effect of all four interventions was a 20.9% (95% CI 7.8-33.9%) relative decrease in PPI use 12 months after the final intervention. The four interventions also resulted in a 42.2% (95% CI 19.9-64.5%) relative increase in low strength PPI use 12 months after the final intervention.
  
  
  CONCLUSIONS
  National multifaceted programmes targeting clinicians and consumers were effective in reducing overall PPI use and increasing use of low strength PPIs. Interventions to improve PPI use should incorporate regular repetition of key messages to sustain practice change.
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001 , Australia.
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Pratt
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001 , Australia.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kalisch Ellett
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia.
authors.forename: Janet K
authors.initials: JK
authors.lastname: Sluggett
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001 , Australia.
authors.forename: Svetla V
authors.initials: SV
authors.lastname: Gadzhanova
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001 , Australia.
authors.forename: Emmae N
authors.initials: EN
authors.lastname: Ramsay
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001 , Australia.
authors.forename: Mhairi
authors.initials: M
authors.lastname: Kerr
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001 , Australia.
authors.forename: Vanessa T
authors.initials: VT
authors.lastname: LeBlanc
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001 , Australia.
authors.forename: John D
authors.initials: JD
authors.lastname: Barratt
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, South Australia 5001 , Australia.
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Roughead
mesh_terms: D000368:Aged; D001315:Australia; D054626:Consumer Health Information; D011307:Drug Prescriptions / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D054328:Proton Pump Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D058996:Quality Improvement / Q000458:organization & administration
chemical_list: D054328:Proton Pump Inhibitors
keywords: Australia; aged; drug utilization; proton pump inhibitors; quality improvement