A One Health Perspective on the Clinical, Behavioural, and Environmental Risks of Chronic Proton Pump Inhibitor Use in Older Adults

This study explores the clinical, behavioural, and environmental risks of chronic proton pump inhibitor (PPI) use in older adults through a One Health perspective. Among 246 participants, 32.5% were receiving PPI therapy, with 91.3% on long-term treatment, frequently lacking clear clinical justification. Polypharmacy, drug interactions, and risky lifestyle behaviours were common. Environmental review highlighted the potential persistence of PPI transformation products in water systems, raising concerns about ecological impact and antimicrobial resistance. These findings underscore the urgency of implementing deprescribing strategies, enhancing patient education, and adopting sustainable prescribing practices that align human and environmental health.