'Why is my PPI not working?'

Managing the reflux patient that remains symptomatic on PPI therapy.

If you are not already a Praxhub member, you will need to register for free before accessing this education. 

Reflux CPD Module for GPs

About this education

Proton pump inhibitors (PPIs) are a mainstay in the treatment of reflux and gastro-oesophageal reflux disease (GORD). Concerns over the quality use of PPIs resulted in the Pharmaceutical Benefits Scheme (PBS) placing prescribing restrictions on subsided PPIs, aimed at reducing the number of patients on high doses and long-term use when not indicated. While high-dose PPI use did decrease as a result, use of low and standard PPI doses also increased - suggesting a strong reliance on PPIs for reflux management remains.

Despite their ubiquity, up to 40% of patients experience 'breakthrough' or 'rebound' reflux symptoms while on standard daily PPI therapy . To avoid potentially unnecessary dose escalation and/or prescription of longer treatment courses, General Practitioners (GPs) need to feel prepared for when patients do not achieve expected/desired results while on PPI therapy, and be able to confidently communicate achievable strategies to help patients manage refractory reflux symptoms. This module provides GPs with a greater understanding of the potential causes of refractory reflux symptoms, comprehensive pathways to resolve unwanted reflux symptoms, and guidance on when to consider other diagnoses or specialist referral.

This module is sponsored by an unrestricted educational grant from Reckitt. All content is the true, accurate and independent opinion of the authors and the views expressed are entirely their own.

1

Outline multimodal reflux treatment strategies incorporating on-demand medicines that can support empiric trial of proton pump inhibitor (PPI) therapy for reflux symptoms

By the end of this activity, you will be able to:

3

Identify patient variables that can contribute to failure of PPI therapy

2

Outline reflux treatment strategies to manage breakthrough symptoms experienced by patients taking maintenance PPI doses

4

Describe further investigations to be undertaken following failure of PPI therapy

Learning Outcomes

Provider Details

The Provider of this activity is Panwar Health. Panwar Health is an authorised Provider of education under the RACGP CPD Program.

This medical education activity has been approved for 1 CPD hour with the RACGP. 

Activity ID: 754406

Continuing Professional Development (CPD) Details

General Practitioner & Medical Educator
Medical Copywriter

Course Authors

This module is sponsored by an unrestricted educational grant from Reckitt. All content is the true, accurate and independent opinion of the authors and the views expressed are entirely their own.

Access this CPD activity plus hundreds more. 
Completely free, anytime, anywhere, on any device.

References: 1. Gastro-oesophageal reflux in adults [published August 2022]. In: Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited; accessed November 2023. https://www.tg.org.au. 2. Drug utilisation sub-committee of the Pharmaceutical Benefits Advisory Committee (DUSC PBAC). Analysis of proton pump inhibitor (PPI) medicines used in the management of gastrointestinal acid related disorders. June 2022. Available from: https://www.pbs.gov.au/info/industry/listing/participants/public-release-docs/2022-06/proton-pump-inhibitor-ppi-medicines-used-in-management-of-gastrointestinal-acid.