The researchers suggest from these findings that limiting PPI use and duration to instances where it is medically indicated may be warranted.
According to an NHS Choices assessment of this study, considering that these drugs are widely used in the UK, these findings may cause concern, however it notes the research has a number of important limitations:
•Study was conducted in a population of mostly white, older US male veterans, which might limit generalisability of the results to whole UK population.
•Deaths can't be linked directly to the use of PPIs.
•Many of deaths occurred in the first year, so could well be linked to underlying causes. There was also no information on cause of death.
•The follow-up period was only 5 years; longer term death outcomes weren't examined.
•Length of follow-up in PPI group was more than two years longer than in H2 blocker group.
•The drugs were all prescribed in outpatient settings. There might be a difference between the groups of people who have their drugs prescribed and those who buy them over the counter.
•This study can't attribute risk to any individual PPI.
The assessment concludes that overall, this large study of good-quality data raises a clear link that needs further examination. It advises that people who have been prescribed PPIs should not stop taking them as the risk of not doing so may be much greater than any risk the drugs pose.