Evaluation of Saudi Adults’ Knowledgeand Awareness Regarding the Risks ofLong-term Use of Proton Pump Inhibitors
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Abstract
Introduction: Proton pump inhibitors (PPIs) are among the most prescribed medications for the management of upper
gastrointestinal disorders. Although they are generally considered safe and effective for short-term use, prolonged or
unsupervised intake has been associated with several adverse health outcomes. In Saudi Arabia, the widespread availability
of PPIs without prescription raises significant concerns regarding public awareness and the potential for inappropriate
use. Objectives: This study aims to assess the awareness and knowledge of Saudi adults concerning the long-term side
effects of PPIs. Materials and Methods: A cross-sectional online survey was conducted from July to December 2025,
targeting Saudi adults aged 18 years and above. Data were collected using a structured and validated questionnaire, with
a minimum sample size of 377 participants, as determined by Raosoft’s sample size calculator. Results: A total of 734
participants completed the survey. Most respondents were female (72.9%) and aged 18–35 years (58.2%). Overall, 62.5%
reported prior PPI use, with 14.0% using PPIs without medical consultation. Gastroesophageal reflux disease (20.0%)
and heartburn (15.1%) were the most common indications. Knowledge regarding long-term adverse effects was limited,
with 76.6% demonstrating low knowledge. Awareness of common side effects, such as nausea (47.4%), was higher than
that of serious complications such as pneumonia (6.8%) and osteoporosis (15.7%). Knowledge level was significantly
associated with gender, marital status, and working or studying in the medical field (P ≤ 0.05). Despite limited knowledge,
attitudes were generally positive, with strong support for public education (90.8%) and stricter regulation of community
pharmacies (85.4%). Conclusion: Saudi adults demonstrate limited knowledge but generally positive attitudes regarding
long-term PPI use, underscoring the need for targeted educational and regulatory interventions.
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