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3 passages
Routine gastroprotection with PPIs for short-term NSAID use is low-value in low-risk patients. Why: Short-term NSAID use in low-risk patients does not require PPI co-prescription; this practice increases cost and potential PPI-related harms.
Unindicated proton pump inhibitor (PPI) and prokinetic combinations (e.g., domperidone+pantoprazole) are low-value. Why: PPIs and prokinetics should be reserved for documented acid-related disorders; routine use increases cost and risk of adverse effects without benefit.
Fixed-dose combinations of a PPI with domperidone are low-value when prescribed without a documented indication. Why: The domperidone+PPI combination is frequently flagged as unindicated.