Digital Proton Pump Inhibitor Prescribing Education at The Point of Prescription: A Real-World Study in a Primary Care Setting.

BACKGROUND: Proton pump inhibitors (PPIs) are frequently prescribed in primary care, often for durations that exceed guideline recommendations. We evaluated whether a digital point‑of‑prescription educational intervention based on the updated March 2023 Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) GERD guideline could influence the prescribing patterns of primary care physicians (PCPs). METHODS: We conducted a 12‑month retrospective cohort study using anonymized prescription data from PCPs in Germany. Intervention physicians (n = 886) received EMR‑integrated pop‑up messages with guideline‑based recommendations and optional links to further content on the "Praxiswelt" (Practice World) educational platform. A matched control group (n = 886) received no messages. Physician engagement (click rates), PPI prescription volume, pack size, and use of ICD‑10 diagnosis codes were compared pre‑ (Q2-Q4 2022) and post‑guideline (Q2-Q4 2023). Analyses were descriptive. RESULTS: A total of 31 629 pop‑ups were displayed (mean 37.7 per physician); of these, 32.7% generated positive interactions, 0.4% negative, and 66.9% no interaction. PPI prescription volume changed by -2.8% in the intervention group versus +0.7% in controls. Most prescriptions exceeded the recommended 8‑week duration (91%-100%). ICD‑10 coding rates remained low (missing codes: intervention 75.2% pre-guideline vs 76.7% post-guideline; controls 90.0% vs 88.1%). CONCLUSION: Digital pop‑up education at the point of prescription produced only minimal changes in prescribing volume and coding behavior. The limited effect may reflect alert fatigue, passive content, and single‑channel delivery. Future strategies should combine point‑of‑prescription alerts with interactive decision support, audit and feedback, and system‑level changes to improve both adherence and documentation.