Inappropriate use of proton pump inhibitors in clinical practice globally: a systematic review and meta-analysis
We read with interest the population-based cohort studies by Abrahami et al on proton pump inhibitors (PPI) and the risk of gastric and colon cancers.1 2 PPI are used at all levels of healthcare and across different subspecialties for various indications.3 4 A recent systematic review on the global trends and practices of PPI recognised 28 million PPI users from 23 countries, suggesting that 23.4% of the adults were using PPI.5 Inappropriate use of PPI appears to be frequent, although there is a lack of compiled information on the prevalence of inappropriate overuse of PPI. Hence, we conducted a systematic review and meta-analysis on the inappropriate overuse of PPI globally. The details of the methodology are described in the online supplemental file. The literature was searched from inception until 19 July 2023 (PubMed, Embase and Scopus) for studies that reported on the inappropriate overuse of PPI. Two investigators independently performed each step, from screening to study selecti