title: Socio-demographic factors influence chronic proton pump inhibitor use by a large population in the Netherlands.
abstract: BACKGROUND
  Chronic proton pump inhibitor (PPI) use is common in the Western world. Socio-economic status and socio-demographic factors have been shown to influence decisions related to prescribing of various drugs, but the influence of these factors on chronic PPI use is uncertain.
  
  
  OBJECTIVE
  To study the influence of SES and socio-demographic factors on chronic PPI use.
  
  
  METHODS
  Data were collected from a database of a Dutch health insurance company. Subjects having had at least one prescription for a PPI were identified and followed up for 6 months. Patients were then subdivided into chronic PPI users. Socio-demographic status was based on neighbourhood level of residence. Logistic regression was performed to determine socio-demographic factors associated with PPI use.
  
  
  RESULTS
  A total of 2 001 787 insured individuals were included, 85 253 subjects were chronic users. Both low income (OR 1.55; CI 1.52-1.58) and low educational level (OR 1.33; CI 1.31-1.36) were associated with chronic PPI use. Other independent predictive variables included use of 10 or more concomitant medications (OR 5.33; CI 4.96-5.72) and the use of prokinetic drugs (OR 10.01; CI 9.22-10.88).
  
  
  CONCLUSIONS
  Patients of a lower socio-demographic status are more likely to use PPIs on a chronic basis. The observed gradient in PPIs use may reflect differences in health, healthcare use or healthcare supply.
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: O S
authors.initials: OS
authors.lastname: van Boxel
authors.forename: M P
authors.initials: MP
authors.lastname: Hagenaars
authors.forename: A J P M
authors.initials: AJ
authors.lastname: Smout
authors.forename: P D
authors.initials: PD
authors.lastname: Siersema
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015331:Cohort Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005767:Gastrointestinal Diseases / Q000188:drug therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors