What is an important monitoring consideration when prescribing PPIs?

When prescribing proton pump inhibitors (PPIs), one of the significant considerations is the risk of hip fractures and the potential impact on vitamin D levels. Long-term use of PPIs has been associated with an increased risk of fractures, particularly in the hip and wrist. This correlation may be due to decreased calcium absorption, which is dependent on a sufficiently acidic environment in the stomach. Since PPIs reduce gastric acid secretion, they could impair the absorption of calcium and possibly lead to deficiencies in vitamin D, which is crucial for calcium metabolism and bone health.

Monitoring for signs of hip fractures is essential, especially in older adults who are already at higher risk for osteoporosis and falls. Additionally, assessing vitamin D levels can be beneficial, given its vital role in maintaining bone density and overall health. Therefore, this focus aligns with best practices in managing patients on long-term PPI therapy and preventing complications related to bone health.