Inappropriate prescribing of gastric acid suppressants: A systematic literature review and meta‐analysis

Abstrakt

Aim Inappropriate prescribing of gastric acid suppressants (GASs) may compromise treatment outcomes. This study aimed to examine the prevalence of inappropriate prescribing of GASs in all healthcare settings. Methods This PROSPERO‐registered systematic literature review used PubMed and Embase databases to identify original English‐language studies published between 1 January 2000 and 15 December 2025. Studies reporting the number of inappropriate GASs prescribing among patients receiving GASs were included. EndNote, Rayyan and ASReview were used to select studies. Results Overall, 141 studies from 44 countries were included. The number of patients in the studies ranged from 36 to 922 436. The pooled prevalence of inappropriate prescribing for all continents was 53% (95% confidence interval [CI]: 49% to 57%), prediction interval 15% to 89%, I 2 = 99.9% and τ 2 = 0.92. Doi plots of the publication bias analysis showed asymmetry in some models (Luis Furuya–Kanamori index = −4.48), but the Copas‐adjusted estimate for the overall dataset was essentially identical to the unadjusted pooled estimate, indicating that although small‐study effects may be present, publication bias is unlikely to affect the overall pooled prevalence. Based on our dataset, we selected several moderators to evaluate. From the selected moderators, we found that the study setting was the factor significantly associated with differences in the pooled prevalence ( P = 0.02). Conclusion Across published studies, approximately half of prescribed GASs was classified as inappropriate. This result highlights the global need for healthcare providers to effectively prevent and discontinue the inappropriate prescribing of GASs.