{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:24:30Z","timestamp":1787300670848,"version":"build-2736575974"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Proton pump inhibitors (PPIs) are often overprescribed in cancer care, leading to unnecessary side effects and increasing healthcare costs. Pharmacists can optimize and improve the rational prescribing of PPIs particularly in low\/middle income countries, where such data is limited. We aimed to evaluate how a pharmacist-led education program affects PPIs rational prescribing and deprescribing in cancer patients through adhering to American Gastroenterological Association (AGA) guidelines, documentation of indication, and reducing costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This quasi-experimental study was conducted at a tertiary care cancer hospital in Peshawar, Pakistan from November 2024 to January 2025. Intervention included physician education via CME sessions and weekly AGA guidelines pamphlet. Data related to patient age, type of cancer, PPI prescriptions, indications for use, documentation, other co-prescribed medicines, and costs were collected. Outcomes included guidelines adherence in terms of changes in PPI prescribing, inappropriate PPI use, and the total costs of therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 400 prescriptions (200 pre- and 200 -post intervention) were analyzed. Inappropriate use without proper indication decreased from 34.3% to 14%. Long-term use without a valid reason also declined from 7.3% to 1.8%. The average cost of treatment dropped from PKR 530\u2009\u00b1\u2009428.6 to 336.4\u2009\u00b1\u2009250.8, with p\u2009&lt;\u20090.001. Significant improvements in adherence to multiple AGA Best Practice Advise (BPA) categories were observed, especially in deprescribing PPIs without definitive indications and step-down dosing. The documentation of indications for PPI use improved from 39.3% to 60.7%, with p\u2009&lt;\u20090.001.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pharmacist-led interventions greatly improved rational PPIs prescribing, enhanced documentation, reduced inappropriate PPI use, and reduced therapy costs in cancer patients. These results support the pharmacist's integration into oncology healthcare team to improve medicine safety, rational use and resource utilization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10781552261478566","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T13:59:42Z","timestamp":1786975182000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacist-led educational intervention for rational prescribing and deprescribing of proton pump inhibitors in cancer patients: A quasi-experimental study from Pakistan"],"prefix":"10.1177","author":[{"given":"Haider","family":"Hikman","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Shaukat Khanum Memorial Cancer Hospital and Research Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Junaid Hassan","family":"Sharif","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qasim","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar Akhlaq","family":"Bhutta","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shaukat Khanum Memorial Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghulam","family":"Mujtaba","sequence":"additional","affiliation":[{"name":"Pakistan Kidney and Liver Institute & Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajjad","family":"Ullah","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shaukat Khanum Memorial Cancer Hospital and Research Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0245-0051","authenticated-orcid":false,"given":"Muhammad","family":"Ashfaq","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.5056\/jnm18001"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-023-03534-z"},{"key":"e_1_3_3_4_2","first-page":"524","article-title":"PRACTICES OF PROTON PUMP INHIBITORS USE IN MEDICAL WARDS: proton pump inhibitors","volume":"67","author":"Hassan GU","year":"2017","unstructured":"Hassan GU, Haque IU, Hameed MA, et al. PRACTICES OF PROTON PUMP INHIBITORS USE IN MEDICAL WARDS: proton pump inhibitors. Pakistan Armed Forces Medical Journal 2017; 67: 524\u2013528.","journal-title":"Pakistan Armed Forces Medical Journal"},{"key":"e_1_3_3_5_2","article-title":"Reduce unnecessary use of proton pump inhibitors","volume":"379","author":"Farrell B","year":"2022","unstructured":"Farrell B, Lass E, Moayyedi P, et al. Reduce unnecessary use of proton pump inhibitors. BMJ 2022; 379: e069211.","journal-title":"BMJ"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nurpra.2024.105159"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/bcpt.13023"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/2042098613482484"},{"key":"e_1_3_3_9_2","first-page":"19","article-title":"Review of the long-term effects of proton pump inhibitors","volume":"34","author":"Lehault WB","year":"2017","unstructured":"Lehault WB, Hughes DM. Review of the long-term effects of proton pump inhibitors. Fed Pract 2017; 34: 19\u201323.","journal-title":"Fed Pract"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-040473"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/8755122515575177"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/2631774520919367"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-019-02810-1"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.13739"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2024.102794"},{"key":"e_1_3_3_16_2","first-page":"354","article-title":"Deprescribing proton pump inhibitors","volume":"63","author":"Farrell B","year":"2017","unstructured":"Farrell B, Pottie K, Thompson W, et al. Deprescribing proton pump inhibitors. Can Fam Physician 2017; 63: 354\u2013364.","journal-title":"Can Fam Physician"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.12.247"},{"key":"e_1_3_3_18_2","article-title":"Interventions to improve the appropriate use of polypharmacy for older people","volume":"10","author":"Cole JA","year":"2023","unstructured":"Cole JA, Gon\u00e7alves-Bradley DC, Alqahtani M, et al. Interventions to improve the appropriate use of polypharmacy for older people. 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