TOPLINE:

Educational pop-up messages to primary care physicians produced only minimal improvements in prescriptions of proton pump inhibitors (PPI), with most prescriptions exceeding the guideline-recommended duration of 8 weeks.

METHODOLOGY:

• A 2023 guideline recommends starting antacids, alginates, or histamine type 2 receptor blockers before PPI and limiting PPI therapy to 4-8 weeks. Researchers assessed whether educational pop-up messages improved PPI prescribing patterns among primary care physicians.
• This retrospective cohort study used prescription data of German primary care physicians for three quarters before and after the release of guideline.
• Real-time pop-up messages with guideline summaries and links to further educational content were shown in the electronic medical records system of 886 primary care physicians, whereas a matched group of 886 received no messages.
• Analyses focused on how physicians engaged with these messages, volume of PPI prescription, duration of therapy, and use of International Classification of Diseases, 10th revision (ICD-10) diagnosis codes.

TAKEAWAY:

• A total of 31,629 messages were displayed with an average of 37.7 per physician. Physicians clicked 32.7% of the messages for additional information, opted out of 0.4%, and closed 66.9% without engaging.
• PPI prescriptions decreased by 2.8% among physicians who received messages but increased by 0.7% among those who did not.
• Most prescriptions (91%-100%) exceeded the recommended 8-week duration, with average supplies of 95-100 days.
• Diagnostic coding remained low; among prescriptions by physicians who received messages, 75.2% lacked an ICD‑10 code before the guideline and 76.7% after, and the corresponding numbers were 90.0% and 88.1% among those who did not receive messages.

IN PRACTICE:

“Healthcare systems should recognize that simple educational interventions alone are insufficient to change complex prescribing behaviors. Multimodal approaches addressing knowledge, workflow, and system-level barriers are likely necessary for meaningful improvement,” the study authors wrote.

SOURCE:

This study was led by Joshua Wray, of Reckitt Benckiser Healthcare Limited in Hull, England. It was published online on October 18, 2025, in Journal of Primary Care & Community Health.

LIMITATIONS:

This study was not randomized, lacked formal testing of statistical hypothesis, and only used descriptive analyses. The impact of prescription changes on patient health outcomes was not assessed.

DISCLOSURES:

This study received funding from Reckitt Benckiser Healthcare Limited. Six authors disclosed being employees of Reckitt Benckiser, and another author reported being an employee of IQVIA.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.