{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:41:22Z","timestamp":1792395682368,"version":"4.4.0"},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T00:00:00Z","timestamp":1792281600000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Proton pump inhibitors (PPIs) are frequently used without long\u2010term indication. Discontinuation remains challenging because of rebound symptoms. Whether digital guidance tools improve discontinuation is unknown. We evaluated whether an app improves PPI discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this open\u2010label adaptive randomised controlled superiority trial, adults using daily PPI for \u2265\u00a04\u00a0weeks without chronic PPI indication, according to the Dutch College of General Practitioners guideline, were recruited from outpatient clinics of Internal Medicine, Gastroenterology, Rheumatology and Nephrology departments at three Dutch hospitals. Patients were excluded if their physician deemed PPI use necessary beyond guideline recommendations, after prior upper gastrointestinal surgery, in case of inability to understand the study, unavailability of a smartphone\/tablet, or limited life expectancy. Patients were randomly assigned (1:1), stratified by department and initial indication, to receive information on PPI discontinuation through an app (intervention) or brochure (control). Primary outcome was PPI discontinuation at 2 months follow\u2010up, defined as self\u2010declared intake of \u2264\u00a01 tablet in the preceding 14\u00a0days. Sample\u2010size was revised earlier than prespecified based on interim data. The trial is registered as closed to accrual at\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      (NCT05348252).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between May 15, 2022, and March 31, 2023, 174 patients were randomized (86 intervention, 88 control). Nine and two patients, respectively, did not receive the allocated intervention. Of the 163 participants (mean age 54\u00a0y\/o [SD 11], 76 males [47%]), 66\/77 (86%) discontinued PPIs in the intervention group versus 55\/86 (64%) in the control group (RR 1.34, 95% CI 1.11\u20131.61,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002). Adverse events occurred in 18\/121 (15%) patients who discontinued PPI use and in 6\/42 (14%) who did not. Only 4\/121 (3%) and 1\/42 (2%), respectively, were potentially attributable to PPI discontinuation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An app\u2010based intervention significantly improves discontinuation of inappropriate PPI use compared with an information brochure and could therefore be considered for PPI deprescribing initiatives.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.70297","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:58:45Z","timestamp":1792393125000},"source":"Crossref","is-referenced-by-count":0,"title":["An App\u2010Based Proton Pump Inhibitor Discontinuation Tool: A Multicentre, Open\u2010Label, Randomised Superiority Trial"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9826-0676","authenticated-orcid":false,"given":"Lieke M.","family":"Koggel","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Radboud University Medical Centre  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2534-5799","authenticated-orcid":false,"given":"Thomas","family":"Timmers","sequence":"additional","affiliation":[{"name":"Interactive Studios  's\u2010Hertogenbosch the Netherlands"},{"name":"IQ Health Science Department Radboud University Medical Centre  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3137-901X","authenticated-orcid":false,"given":"Marten A.","family":"Lantinga","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Radboud University Medical Centre  Nijmegen the Netherlands"},{"name":"Department of Gastroenterology and Hepatology Amsterdam Gastroenterology Endocrinology Metabolism Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3134-487X","authenticated-orcid":false,"given":"Rudolf B.","family":"Kool","sequence":"additional","affiliation":[{"name":"IQ Health Science Department Radboud University Medical Centre  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5398-6414","authenticated-orcid":false,"given":"Cornelis","family":"Kramers","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Pharmacology and Toxicology Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noortje","family":"van Herwaarden","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Pharmacology and Toxicology Radboud University Medical Center  Nijmegen the Netherlands"},{"name":"Department of Rheumatology Sint Maartenskliniek  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5718-8654","authenticated-orcid":false,"given":"Peter D.","family":"Siersema","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Radboud University Medical Centre  Nijmegen the Netherlands"},{"name":"Department of Gastroenterology and Hepatology Erasmus MC University Medical Center  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"SUPPORT study consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.13766"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.1901"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2020.05.005"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2022.0178"},{"key":"e_1_2_9_6_1","unstructured":"M. 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