Trends in prescribing H2-receptor antagonists and proton pump inhibitors in primary care.
BACKGROUND
H2-receptor antagonists and proton pump inhibitors account for approximately 15% of primary care prescribing costs in the UK.


OBJECTIVE
To examine the use of antisecretory drugs in primary care between October 1991 and September 1996.


METHODS
Analysis of prescribing data from an ongoing postal survey performed every 3 months on a rolling quota of 250 UK general practitioners (GPs), identified from a representative sampling frame of 1000 GPs.


RESULTS
There were 8811 new courses of proton pump inhibitors and 11,948 new courses of H2-receptor antagonists during this study. The number of new prescriptions for proton pump inhibitors increased by 174.5%, but decreased for H2-receptor antagonists by 12.5%. Proton pump inhibitors were mostly prescribed for reflux disease (52.7%) and H2-receptor antagonists for non-specific dyspepsia (43.6%). Proton pump inhibitors (14.1%) were less likely to be stopped than H2-receptor antagonists (35.3%) overall, and they were less likely to be stopped because of perceived ineffectiveness (5.3%) than H2-receptor antagonists (23.8%). The rate of stopping treatment because of side-effects was about 3% for both classes of drug.


CONCLUSIONS
Prescribing of proton pump inhibitors has increased sharply each year since 1991. One reason may be that GPs perceive proton pump inhibitors to be more effective than H2-receptor antagonists.
Martin
R M
RM
Division of General Practice and Primary Care, St George's Hospital Medical School, London, UK.
Lim
A G
AG
Kerry
S M
SM
Hilton
S R
SR
D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004415:Dyspepsia / Q000188:drug therapy; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D010349:Patient Compliance; D011320:Primary Health Care / Q000706:statistics & numerical data* / Q000639:trends; D054328:Proton Pump Inhibitors; D016896:Treatment Outcome; D006113:United Kingdom
D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors