{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:57:46Z","timestamp":1790891866134,"version":"4.1.0"},"reference-count":0,"publisher":"SMW Supporting Association","issue":"9","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Swiss Med Wkly"],"abstract":"<jats:p>BACKGROUND: Proton-pump inhibitors (PPI) are a key treatment for gastro-oesophageal disease, but their frequent overprescription leads to potential adverse effects and an economic burden. In this retrospective study, we investigated the effect of a Smarter Medicine guideline published in May 2014 by the Swiss Society of General Internal Medicine, which recommended that general practitioners should avoid \u201clong-term treatment of gastrointestinal symptoms with proton-pump inhibitors without titrating to the lowest effective dose needed\u201d.\nMETHODS: An interrupted time-series analysis was performed using a Seasonal AutoRegressive Integrated Moving Average (SARIMA) model, which was validated through a Bayesian Model Averaging algorithm with changepoint detection. National PPI sell-in data was provided by IQVIA and covered 100% of oral and intravenous PPIs distributed in Switzerland from 2009 to 2019. The main outcome was the monthly number of oral PPI defined daily doses (DDD) per 100,000 inhabitants aged \u226520 years. A regression analysis was conducted to estimate pre-guideline trend, post-guideline level change and post-guideline slope change. Using Bayesian Model Averaging, the probability of changepoint occurrence over time was calculated without predetermined intervention dates. Oral PPI DDDs were used as a surrogate for outpatient prescriptions, while intravenous PPI DDDs served as a control in Bayesian Model Averaging.\nRESULTS: Following guideline publication, a significant post-guideline downward trend of oral PPI DDDs was observed (slope change, p &lt;0.001). Bayesian analysis of oral PPI DDDs supported a single changepoint with 92% probability, most likely occurring within 2 years after guideline publication (79% summed changepoint occurrence probability). For intravenous DDDs, the probability of a single changepoint dropped to 41%, with only 29% summed probability for the same period.\nCONCLUSIONS: A significant downward trend in PPI oral DDDs was observed after the Smarter Medicine guideline publication, suggesting that primary care guidelines have the potential to induce change in prescribing behaviour.<\/jats:p>","DOI":"10.57187\/5204","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:20:24Z","timestamp":1790889624000},"page":"5204","source":"Crossref","is-referenced-by-count":0,"title":["Impact of a national Smarter Medicine guideline on outpatient proton-pump inhibitor prescription in Switzerland: a nationwide interrupted time-series analysis"],"prefix":"10.57187","volume":"156","author":[{"given":"Fran\u00e7ois","family":"Panosetti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorian","family":"Bachmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Richard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Genn\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"36756","published-online":{"date-parts":[[2026,9,30]]},"container-title":["Swiss Medical Weekly"],"original-title":[],"link":[{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/download\/5204\/6715","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/download\/5204\/6716","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/download\/5204\/6715","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:20:24Z","timestamp":1790889624000},"score":1,"resource":{"primary":{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/view\/5204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":0,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.57187\/5204","relation":{},"ISSN":["1424-3997"],"issn-type":[{"value":"1424-3997","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]}}}