title: Pediatric gastroesophageal reflux disease and acid-related conditions: trends in incidence of diagnosis and acid suppression therapy.
abstract: OBJECTIVE
  To describe the incidence of diagnosis of gastroesophageal reflux disease and acid-related conditions (GERD/ARC) throughout childhood and characterize patterns of diagnosis and treatment with proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H(2)RAs).
  
  
  METHODS
  Cohorts of GERD/ARC children (age 0-18 years) were identified from a large US administrative claims database covering 1999-2005 using ICD-9 codes. Incidence, healthcare utilization (HCU), costs, therapy discontinuation and switching rates were compared between various age and patient groups.
  
  
  RESULTS
  Between 2000 and 2005 annual incidence of GERD/ARC diagnosis among infants (age ≤1 year) more than tripled (from 3.4 to 12.3%) and increased by 30% to 50% in other age groups. Patients diagnosed by GI specialists (9.2%) were more likely to be treated with PPIs compared to patients diagnosed by primary care physician (PCP). PPI-initiated patients doubled (from 31.5% in 1999 to 62.6% in 2005) and, when compared with H(2)RA-initiated patients, were associated with 30% less discontinuation and 90% less therapy switching in the first month, and with higher comorbidity burden and pre-treatment total HCU and costs when diagnosed by GI specialists.
  
  
  CONCLUSIONS
  The use of an exploratory definition for GERD/ARC, administrative claims data and potential coding errors in diagnosis codes used in selection process may limit the generalizability of the results.
  
  
  CONCLUSIONS
  GERD/ARC incidence increased for children of all ages between 2000 and 2005. PCPs made the majority of diagnoses. PPI initiations have now surpassed H(2)RA initiations.
authors.affiliation: The Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: S P
authors.initials: SP
authors.lastname: Nelson
authors.forename: S
authors.initials: S
authors.lastname: Kothari
authors.forename: E Q
authors.initials: EQ
authors.lastname: Wu
authors.forename: N
authors.initials: N
authors.lastname: Beaulieu
authors.forename: J M
authors.initials: JM
authors.lastname: McHale
authors.forename: O H
authors.initials: OH
authors.lastname: Dabbous
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D005260:Female; D005759:Gastroenteritis / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology*; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology*; D006635:Histamine H2 Antagonists / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007345:Insurance Claim Review; D016015:Logistic Models; D008297:Male; D054328:Proton Pump Inhibitors / Q000191:economics / Q000627:therapeutic use*; D014481:United States / Q000453:epidemiology
chemical_list: D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors