First-time endoscopy and use of antisecretory medication: a population-based cohort study.
OBJECTIVE
Endoscopy is the gold standard for diagnostic evaluation of upper gastrointestinal symptoms. The relation between endoscopy and use of antisecretory medication on a population level is unknown. The aim of this study was to describe development in the number of patients undergoing first-time endoscopies and their use of antisecretory medication.


METHODS
Data on the use of endoscopies and antisecretory medication (H2 blockers and proton-pump inhibitors) were extracted from five population-based databases and included all citizens in Funen County (population 470,000) who had first-time endoscopies between 1993 and 2002.


RESULTS
A total of 27,829 first-time endoscopy patients were identified. In 2002 the number of first-time endoscopies was 5.6/1000 persons. The proportion that had redeemed prescription(s) on antisecretory medication the last year before endoscopy increased from 33% (1095/3286) in 1993 to 41% (1012/2445) in 2002 (p = 0.000). Following endoscopy, average use of antisecretory medication increased by 90 defined daily doses (DDD)/patient/year (95% CI 84-96) in patients with oesophagitis (N = 4850), by 59 DDD/patient/year (95% CI 54-64) in peptic ulcer patients (N = 4373) and by 18 DDD/patient/year (95% CI 16-20) in patients with normal endoscopies (N = 16,400).


CONCLUSIONS
An increasing proportion of patients are treated with antisecretory medication before endoscopy. Following endoscopy, use of antisecretory medication increases irrespective of the diagnostic findings.
Lassen
Annmarie
A
Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark. Annmarie.lassen@ouh.fyns-amt.dk
Hallas
Jesper
J
De Muckadell
Ove B Schaffalitzky
OB
D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D016001:Confidence Intervals; D003718:Denmark; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005773:Gastroscopy / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010437:Peptic Ulcer / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D054328:Proton Pump Inhibitors; D012042:Registries; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors