Randomised controlled trialindependent cross-checkfull text checked★ key study I-PPI-106 in-depth review

Most people could stop unnecessary acid blockers

An App-Based Proton Pump Inhibitor Discontinuation Tool: A Multicentre, Open-Label, Randomised Superiority Trial.

Overview

Koggel LM et al.. United European Gastroenterol J 2026 · PMID 42894466 · DOI 10.1002/ueg2.70297

Among outpatients without a reason for long-term PPIs, 86% using an app and 64% using a leaflet had stopped after 2 months.

Does the study support the specific claim? No · Methodological quality: moderate

Study explained simply

What did the researchers want to find out?: Help people stop unneeded PPIs.
How was the study done?: Randomised trial, app vs brochure.
How many people, animals or samples were studied?: 163 Dutch outpatients.
What was actually found?: 86% vs 64% stopped; few side effects.
How large was the observed effect?: RR 1.34 (1.11-1.61).
What do the results mean in everyday life?: Stopping is usually possible with good information.
What are the study's limitations?: Short follow-up; self-report.
What does it say about Elawady's specific claim?: Contradicts 'cannot stop'.
Do the results apply to Germany and Europe?: Directly applicable.
What can explicitly not be concluded from this study?: Cannot tell how many restart later.

Authors: Koggel LM et al.
Journal: United European Gastroenterol J
Year: 2026
Identifier: PMID 42894466 DOI 10.1002/ueg2.70297
Verification: verified – PubMed efetch 2026-10-26 + Crossref 2026-10-26
Retracted: no
Corrections: none
Extent checked: full text
Conflicts of interest and funding: No sponsor or funder; one author co-founded the app company; others report industry funding unrelated (full text)

Does an app-based discontinuation tool improve stopping of PPIs used without a chronic indication?

Study design: Randomised controlled trial – Multicentre, open-label, adaptive randomised superiority trial
Population: Adults using daily PPI >=4 weeks without chronic indication (Dutch GP guideline), outpatients of 3 Dutch hospitals
Country: Netherlands
Period: May 2022 - March 2023
Sample size: 174 randomised; 163 analysed
Inclusion and exclusion criteria: Excluded if physician deemed PPI necessary, prior upper GI surgery, no smartphone, limited life expectancy

Exposure / intervention: App with information and tapering guidance
Comparator: Information brochure
Endpoints: Discontinuation at 2 months (<=1 tablet in prior 14 days); adverse events
Statistical methods: Risk ratio; adaptive sample size with Pocock-type correction

Results: Discontinued: 66/77 (86%) app vs 55/86 (64%) brochure; RR 1.34 (1.11-1.61). Adverse events 18/121 (15%) of those who stopped vs 6/42 (14%) who did not; 4/121 (3%) possibly attributable to discontinuation.
Absolute risks: 64-86% stopped within 2 months; 3% had adverse events possibly due to stopping
Authors' conclusion: An app-based intervention significantly improves discontinuation of inappropriate PPI use compared with a brochure.

Recomputed RR 1.34 (1.12-1.61) matches; Wilson CI for brochure arm 53%-73% (stats/C-PPI-06_07_rebound_discontinuation.py).

Direct evidence that most people taking PPIs without an indication can stop within 2 months, even with only a brochure.

Long-term relapse unknown.

Directly applicable to Europe.

Strong contradiction of 'one cannot stop'.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	moderate
Risk of bias	some concerns
Precision of results	moderate
Directness	direct
Reproducibility	not replicated
Consistency with the overall evidence	consistent
Regional transferability	high
Adequacy of the interpretation (by the archive)	not applicable

Sustained discontinuation beyond 2 months.