Users and utilization patterns of over-the-counter acid inhibitors and antacids in The Netherlands.
OBJECTIVE
General practitioners (GPs) are the first-line physicians who are consulted for upper digestive symptoms. Persons with symptoms may, however, prefer to buy acid inhibitors or antacids in drugstores or pharmacies and bypass a GP. The aim of this work was to study users, reasons for use, and utilization patterns of over-the-counter (OTC) acid inhibitors and antacids in The Netherlands. We also studied factors that were associated with the substitution of OTC acid inhibitors or antacid use for consultation with a GP.


METHODS
From July 2005 to January 2006, persons buying OTC acid inhibitors or antacids in 12 pharmacies and 4 drugstores were asked to complete a questionnaire. A total of 82/160 (51%) questionnaires were returned.


RESULTS
Heartburn was the main symptom for buying an acid inhibitor or antacid. Seventy-one (87%) participants substituted OTC drug use for a GP consultation. The most commonly reported reason was the belief that symptoms were not serious enough to seek medical care. Exploratory analyses showed that substitution was less common in participants with comorbidity, a history of upper gastrointestinal disorder, use of an acid inhibitor or antacid previously prescribed by a physician, alarm symptoms (such as pain and nausea), and with being symptomatic for >4 days/week.


CONCLUSIONS
Although the reasons for substitution of OTC acid inhibitor or antacid use for a GP consultation in The Netherlands do not suggest an a priori increased risk of an underlying serious disorder, it may be advisable for staff in drugstores and pharmacies to provide users with information on appropriate use and when to consult a GP.
Department of Gastroenterology, Rotterdam, The Netherlands. e.p.m.vanvliet@erasmusmc.nl
Evelyn P M
EP
Van Vliet
Ernst J
EJ
Kuipers
Ewout W
EW
Steyerberg
Peter D
PD
Siersema
D000863:Antacids / Q000191:economics / Q000627:therapeutic use*; D004066:Digestive System Diseases / Q000188:drug therapy; D016527:Drug Costs; D011307:Drug Prescriptions; D004363:Drug Utilization; D005194:Family Practice; D005260:Female; D006356:Heartburn / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D004366:Nonprescription Drugs / Q000191:economics / Q000627:therapeutic use*; D012651:Self Medication; D011795:Surveys and Questionnaires
D000863:Antacids; D004366:Nonprescription Drugs