Antacid (A02A) and antiulcer (A02B) drug prescription patterns: predicting factors, dosage and treatment duration.
BACKGROUND
A study is made of the pharmaco-epidemiology of antacid (ATC class A02A) and antiulcer (A02B) drug prescriptions during the year 1992.


METHODS
Prescription data were extracted from 1941 case histories of patients over 15 years old from four health care centers in the Valencian Community (Spain). Dosage and treatment duration were evaluated, along with the way in which morbidity, self-evaluated health, the demographic pattern and life-style characteristics influence drug prescription.


RESULTS
The proportion of drug prescriptions increased with age in both sexes (p < 0.01). Drug use depended mainly on chronic diseases. In prescribing antacids, the most influential diagnosis was gastritis (ICD 534, OR: 157), followed by duodenal ulcer (ICD 532, OR: 152) and gastric ulcer (ICD 531, OR: 122), other gastrointestinal disorders (ICD 66, OR: 54) and undefined diagnoses (OR: 15). In the prescription of antiulcer drugs, the most influential diagnoses were gastric and duodenal ulcer (OR: 380 and 342, respectively), and a significant relation was observed with the diagnosis of osteomuscular diseases (OR: 6). Lifestyle and demographic pattern were of marginal importance. The estimated duration of treatment was 85 days. No significant differences were observed in either treatment duration or administered doses of almagate, ranitidine and omeprazole with respect to sex, age or diagnosis.


CONCLUSIONS
Prolonged treatment is common for acid suppression. The widespread use of peptic ulcer drugs is mostly due to excessive prescription for non-ulcer dyspepsia. At the same time, many patients consume these drugs on a long-term basis in the absence of a clear diagnosis. This observation supports the need for appropriate diagnostic and prescription protocols to secure increased economical savings and management results.
Unit of Public Health, Hygiene and Environmental Care, Faculty of Pharmacy, University of Valencia, Dr. Peset Hospital, Spain.
M M
MM
Morales Suárez-Varela
M A
MA
Pérez-Benajas
V J
VJ
Girbes Pelechano
A
A
Llopis-González
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000536:Aluminum Hydroxide / Q000008:administration & dosage; D000704:Analysis of Variance; D000863:Antacids / Q000008:administration & dosage*; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D002254:Carbonates / Q000008:administration & dosage; D003625:Data Collection; D004066:Digestive System Diseases / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D011307:Drug Prescriptions / Q000592:standards / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008276:Magnesium Hydroxide / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage; D010437:Peptic Ulcer / Q000188:drug therapy; D017891:Pharmacoepidemiology; D011899:Ranitidine / Q000008:administration & dosage; D012494:Sampling Studies; D017678:Sex Distribution; D013030:Spain
D000863:Antacids; D000897:Anti-Ulcer Agents; D002254:Carbonates; C043698:almagate; D000536:Aluminum Hydroxide; D011899:Ranitidine; D009853:Omeprazole; D008276:Magnesium Hydroxide