Drug Performance Indicators, Cons and Pros Upon Extended use or Misuse of Proton Pump Inhibitors

Background: Proton Pump Inhibitors (PPIs) have progressively replaced the traditional therapies for acid-related diseases and are effectively used in treatment and prophylaxis from peptic ulcer disease and Gastro Esophageal Reflux Disease (GERD). Aim: Evaluation of the indicators, cons and pros upon extended use or misuse of PPIs among Saudi and Egyptian patients. Methods: A cross-sectional survey was distributed throughout Saudi and Egyptian patients who received PPIs, interviewed (Face to Face) and asked questions according to well-designed questionnaire about benefits and adverse effects upon short and long-term use of PPIs. Saudi patients were chosen from university of Ha’il Clinic, KSA and healthcare centers, while Egyptian patients were from different private medical centers, Egypt between October 2024 to December 2024. Data was collected and statistically analyzed using SPSS software (Inc, Chicago, IL, USA, version 25). Results: The mean of participant ages in years (35.99±1.46 Saudis vs. 45.65±3.16 Egyptians). About 46.2% of Saudi participants vs. 67.9% of Egyptian are working in the medical field and low percentage of Saudis who used PPI according to medical consultant are 24.3% vs. Egyptians 68.2%. High percentage of Egyptian participants using PPIs for prophylaxis from peptic ulcers mainly due to long term usage of NSAIDs followed treatment of heartburn. While high percentage of Saudi participants using PPI for treatment of GERD more than Egyptians. High percentages of Egyptian patients completed the course of PPI compared to Saudis and the causes of uncompletion in Saudis due to disappearance of symptoms and presence of side effects more than Egyptians (p-value<0.05). Mild side effects due to using PPI was higher percentage among Egyptian vs. Saudi participants (p-value<0.05). The most predominant side effects were bloating followed by headache then nausea, abdominal pain and diarrhea. Severe side effects due to long-term PPIs usage was higher among Egyptian vs. Saudi participants but not significantly different. The most predominant side effect was osteoporosis followed by increased risk of fractures, iron deficiency anemia, then mineral deficiency. On the other hand, Saudi participants suffered more from deterioration of kidney functions, increase risk of gastroenteritis, dementia and gastric cancer than Egyptian. Conclusion: The long-term hazards, such as kidney disease, fractures and infections, require careful thought and constant monitoring, even if the short-term side effects are usually modest and controllable. Such risks are further boosted by PPIs misuse and over-prescription, which highlights the importance to follow guidelines based on evidence for its usage. Relatively high number of participants developed severe side effects like osteoporosis and increased risk of fractures which are not common in young age group. This indicates that physicians, pharmacists and patients should be cautious on prescribing or taking PPIs even if the patient within young age. To ensure secure and effective use of these important medications in the future, patients and healthcare professionals need to work together and the risks of using long-term PPI must be weighed against the benefits.