Patient Journey Application for Discontinuing Inappropriate PPI Use: a Randomized Controlled Trial

Rationale/objective: This study hypothesizes that offering patient-tailored and dosed information on PPI discontinuation in patients with inappropriate chronic PPI use will result in an increased discontinuation rate when compared to a conventional information folder offering all information on discontinuing inappropriate PPI use at once. Study design: Multicenter randomized controlled trial. Study population: A minimum 152 patients with chronic PPI use without a valid indication for chronic PPI use according to the NHG-guidelines will be included. Possible participants will be identified at the outpatient clinics of the departments of Internal Medicine, Gastroenterology, Rheumatology and Nephrology in the Radboud University Medical Center, Canisius Wilhelmina Hospital and Sint Maartenskliniek. Intervention: Timely informing patients on discontinuing PPI use through the Patient Journey App. Control: Conventional information, consisting of an online information folder on discontinuing PPI use. Inclusion criteria: * Patients with daily PPI use for at least 4 weeks; * Age 18-70 years. Exclusion criteria: * Chronic PPI indication according to NHG-guidelines; * Chronic PPI indication according to treating physician, despite absence of chronic PPI indication according to NHG-guidelines; * Patients that underwent anti-reflux surgery; * No understanding of the study or study procedures including the digital application (smartphone/computer skills); * No smartphone/computer available; * No informed consent; * Limited life span. Primary end point: \- Discontinuation of PPI use at 2-month follow-up, defined as self-declared intake of a maximum of 1 tablet in the previous 14 days. Secondary end points: * Upper gastrointestinal symptoms or disorders that are potentially related to discontinuation of PPI use, subdivided as: * Upper gastrointestinal symptoms as measured by the Patient Assessment of Gastrointestinal Symptom Severity Score (PAGI-SYM); * Any upper ga