Proton pump inhibitors in general medicine. Comparison of routine practices with marketing authorization indications.
OBJECTIVE
To determine whether inaugural prescriptions for proton pump inhibitors (PPI) written by general practitioners in the Grenoble region are in non-compliance with the indications of the French drug marketing authorization.


METHODS
The study was conducted on all inaugural PPI prescriptions written by general practitioners in Grenoble region between March 1 and March 31, 2004. Analyses were performed on a random sample of 600 representative prescriptions. A questionnaire was sent to the general practitioners who had written these prescriptions. There were 255 responses which could be analyzed.


RESULTS
Among the 19,983 prescriptions for PPIs written in March 2004, 4, 442 (22.8%) were first-time treatments. 85.9% of them were issued by general practitioners. The main reasons for prescription identified in the study sample were the association with other drugs [56.1%; 95%CI 50.0-62.2], gastroesophageal reflux disease [29.4%; 95%CI 23.8-35.0] and dyspepsia [11.4%; 95%CI 7.5-15.3]. The rate of non-compliance with the marketing authorization was 46.3% [95%CI 40.2-52.4], including 20.4% [95%CI 15.5-25.3] for inappropriate medical indications.


CONCLUSIONS
General practitioners were the principal prescribers of inaugural PPI treatments. Even after excluding prescriptions which were non-compliant because of a regulatory problem, one out of five prescriptions were written for inappropriate medical indications.
Levy-Neumand
Olivier
O
Service du Contrôle Médical de l'Assurance Maladie, Grenoble. olivier.levy-neumand@elsm-grenoble.cnamts.fr
Carniaux
François
F
Bonaz
Bruno
B
Durand
Aurélie
A
Roblin
Xavier
X
D000465:Algorithms; D003430:Cross-Sectional Studies; D004345:Drug Industry; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005194:Family Practice; D005260:Female; D005602:France; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D054328:Proton Pump Inhibitors; D011795:Surveys and Questionnaires
D005765:Gastrointestinal Agents; D054328:Proton Pump Inhibitors