Clinical trial: long-term use of proton pump inhibitors in primary care patients - a cross sectional analysis of 901 patients.
BACKGROUND
The use of proton pump inhibitors (PPIs) is extensive. While the incidence of new treatments remains stable, the prevalence of long-term treatment is rising. Studies have shown that up to 70% of patients on chronic acid suppression lack a verified indication for treatment.


OBJECTIVE
To investigate primary care patient characteristics associated with long-term use of PPIs.


METHODS
A cross-sectional analysis of 42,634 patients registered with 22 general practitioners was performed. Patients with prescriptions of > or =120 tablets/year were defined as long-term users. A survey of a subgroup of patients without verified indication was performed.


RESULTS
In all, 901 (2.1%) patients were long-term treated. Verified indications for treatment were identified for 247/901 (27%). An upper GI endoscopy had been performed in 418 patients (46%). Of the 194/654 without verified indication who participated in the survey, 71% reported heartburn/acid regurgitation as the reason for therapy. On-demand therapy was reported by 43/194 (22%) and previous attempts to withdraw by 119/194 (61%).


CONCLUSIONS
The prevalence of PPI long-term treatment among primary care patients is 2.1%. The main reason for treatment is reflux symptoms or verified GERD. Rationalization of use of PPIs is possible as daily treatment without attempts to discontinue is frequently observed.
Reimer
C
C
Department of Medical Gastroenterology, Køge Hospital, Copenhagen University, Copenhagen, Denmark.
Bytzer
P
P
D004334:Drug Administration Schedule; D004812:Epidemiologic Methods; D005194:Family Practice; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006356:Heartburn / Q000188:drug therapy*; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors
D054328:Proton Pump Inhibitors