Conclusions We demonstrate a significant association between the use of PPIs and increased risk of fall .
In addition , there is potentially higher risk of fall among PPIs users over time
Background Fall prevention among older adults is a worldwide public health advocacy because of negative consequences of fall .
Recent studies have shown that proton pump inhibitors ( PPIs ) increase the risk of fall .
PPIs are among the widely prescribed medications oftentimes without clear indications .
Concerns for safety of long-term use of PPIs have been raised by numerous studies .
Magnitude and economic effect of overuse of antisecretory therapy in the ambulatory care setting.
OBJECTIVES To determine the prevalence and economic effect of inappropriate proton pump inhibitor ( PPI ) use in an ambulatory care setting . STUDY DESIGN Retrospective medical record review of r and om sample with subgroup analysis . METHODS Patients were categorized according to appropriateness of pharmacotherapy  based on documented upper gastrointestinal tract diagnoses , gastrointestinal or extraesophageal symptoms , or gastroprotection . Adverse events potentially associated with PPI use were identified . RESULTS Of 946 patients in an ambulatory care setting , 35.4 % were given PPI therapy for an appropriately documented upper gastrointestinal tract diagnosis , 10.1 % received PPIs empirically for symptomatic treatment based on extraesophageal symptoms , 18.4 % received PPIs for gastroprotection , and 36.1 % had no documented appropriate indication for PPI therapy . In a subgroup analysis , 48.6 % of patients across all 4 categories received PPIs without documentation of reevaluation of upper gastrointestinal tract symptoms , accounting for 1034 patient-years of PPI use . The total cost of inappropriate PPI use was $ 233,994 based on over-the-counter PPI costs and $ 1,566,252 based on average wholesale price costs . Potentially related adverse events in this cohort included Clostridium difficile – associated diarrhea ( 6 cases ) and community-acquired pneumonia ( 1 case ) , but no cases of hip fracture or vitamin B12 deficiency were identified . CONCLUSIONS Proton pump inhibitors are often overused in the ambulatory care setting without documented valid indications . Inappropriate use of PPIs is associated with substantial cost expenditure and with the potential for adverse events
Conclusions We demonstrate a significant association between the use of PPIs and increased risk of fall .
In addition , there is potentially higher risk of fall among PPIs users over time
Background Fall prevention among older adults is a worldwide public health advocacy because of negative consequences of fall .
Recent studies have shown that proton pump inhibitors ( PPIs ) increase the risk of fall .
PPIs are among the widely prescribed medications oftentimes without clear indications .
Concerns for safety of long-term use of PPIs have been raised by numerous studies .