Assessing NSAID prescription use as a predisposing factor for gastroesophageal reflux disease in a Medicaid population.
OBJECTIVE
The purpose of the study was to determine the incidence of GERD associated with prescription NSAID consumption.


METHODS
All Georgia Medicaid patients > 25 years of age and continuously eligible for 1996, 1997, and 1998 were included in the study. Patients were excluded if they received a GERD diagnoses during 1996 and 1997. Patients were observed in 1998 and classified into GERD and control cohorts. Comorbidities, demographics, and NSAID prescription consumption were retained and modeled with logistic regression.


RESULTS
The absolute risk of developing GERD without previous NSAID consumption was 0.38. The absolute risk of developing GERD for those patients who consumed one or more NSAID prescriptions during 1996 and 1997 was 0.80. Thus, the relative risk of GERD for NSAID patients was 2.11. GERD was significantly associated with one or more NSAID prescriptions (OR = 1.82), age (OR = 1.05 for 5 year range), gender (OR = 1.31 for females), asthma (OR = 3.24), obesity (OR = 2.77), hiatal hernia (OR = 4.17), tobacco use (OR = 2.56), and alcohol (OR = 1.83). The initial NSAID prescription was responsible for the greatest marginal increase in GERD.


CONCLUSIONS
Our study suggests that NSAIDs are associated with GERD especially for females, alcohol and tobacco users, and patients with asthma, hiatal hernia, or obesity.
Kotzan
J
J
College of Pharmacy, University of Georgia, Athens 30602, USA. jkotzan@rx.uga.edu
Wade
W
W
Yu
H H
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D000328:Adult; D000367:Age Factors; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D011307:Drug Prescriptions; D004363:Drug Utilization; D005260:Female; D005764:Gastroesophageal Reflux / Q000139:chemically induced* / Q000453:epidemiology*; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D011153:Population; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment
D000894:Anti-Inflammatory Agents, Non-Steroidal