Long-Term Proton Pump Inhibitor Therapy Is Common Among Older Adults: An 8-Year Finnish Nationwide Register Study.

BACKGROUND

Proton pump inhibitors (PPIs) are widely prescribed for acid-related gastrointestinal conditions, yet concerns persist regarding their long-term use, particularly among older adults, due to potential adverse effects and frequent lack of clear indications. This study examined nationwide trends and patterns of PPI use in Finland, with a specific focus on long-term use among older adults.

METHODS

We used nationwide prescription data from the Finnish Prescription Centre (2017-2024) to examine PPI use in older adults (aged ≥ 65 years), with working-age adults (aged 18-64 years) as a comparison group. Patterns of PPI use, initiation, long-term use (≥ 3 dispensations/year), polypharmacy, and co-medication with antithrombotic agents, corticosteroids, and nonsteroidal antiinflammatory drugs were analyzed using descriptive statistics.

RESULTS

Between 2017 and 2024, the number of PPI users increased by 12% and dispensations by 37%, with a steeper increase among older than working-age adults. In 2024, nearly half of all PPI users were aged ≥ 65 years, of whom 56.3% were classified as long-term users, compared with 34.1% among working-age adults. Long-term PPI use increased in both age groups, with an approximately 2.5-fold higher relative annual increase among older adults than among working-age adults. Long-term PPI use was more common among female than male individuals across nearly all age groups. Among older adults, PPI use was frequently accompanied by polypharmacy: 47% used more than ten other prescription medicines, and 39% received anticoagulants.

CONCLUSIONS

Long-term PPI use is highly prevalent among older adults in Finland. These findings highlight the need for regular medication reviews and targeted deprescribing efforts to improve pharmacotherapy quality and safety in aging populations.