Optimizing Proton Pump Inhibitors (PPI) Prescribing With EHR-Based Decision Support

Quality Improvement Initiative Leveraging Electronic Healthcare Records to Reduce Inappropriate Proton Pump Inhibitors (PPI) Prescribing at UCLA.

The proposed study is a quality improvement initiative designed to rigorously evaluate new variations of UCLA Health's proton pump inhibitor (PPI) order panels, building on internal quality improvement efforts to optimize prescribing workflows within the Electronic Health Record (EHR). PPIs are notoriously overprescribed, and the study team has identified that the CareConnect default prescription setting of 90 days with three refills (360 pill days) exceed standard guidelines (in most cases, 60 pill days). It is unclear whether this is the most appropriate workflow. Given that deprescribing PPIs carries minimal risk for most patients, this initiative will assess whether modifying defaulted prescription lengths influences prescribing behavior while ensuring physicians retain full decision-making authority.

This evaluation of PPI order panel variations is embedded within UCLA's existing EHR system, ensuring that changes are tested pragmatically within routine workflows. The study aims to determine whether small adjustments to the order panel can better align prescribing patterns with clinical best practices while maintaining physician autonomy.

Inclusion Criteria:

• UCLA Health primary care physicians who have a clinical full-time equivalency of at least 25%.

Exclusion Criteria:

• Physicians with a clinical full-time equivalency of less than 25%