title: Use of antacids, alginates and proton pump inhibitors: a survey of the general Danish population using an internet panel.
abstract: OBJECTIVE
  Both over-the-counter medicine, such as antacids or alginates, and proton pump inhibitors (PPI) are used for treating acid-related disorders. We sought to describe what characterizes users of these different medicines, including long-term PPI users within the general population.
  
  
  METHODS
  A cross-sectional survey was conducted in an internet panel representative of the Danish adult population in 2012. Data queried included antacid/alginate and PPI use, reason for therapy, co-medication, and presence of upper gastrointestinal symptoms. Long-term PPI use was defined as using PPI ≥1/3 of the last year (∼120 days). Risk of long-term PPI use was estimated by logistic regression.
  
  
  RESULTS
  A total of 18,223 people received the questionnaire, of which 52% (9390) responded. Antacid/alginate use was reported by 23%; 16% reported use of only antacid/alginate. PPI use was reported by 13.6%; 6.2% were defined as long-term PPI users. Antacid/alginate users were younger, used less co-medication, had most often started on therapy because of reflux symptoms, and had less often ongoing symptoms. Risk of long-term PPI use appeared to be increased in male gender, by renewing PPI prescription by phone/e-mail, using co-medication, and having started on PPI for several reasons. Combination of antacid/alginate and PPI was reported by approximately 50% of those on therapy with weekly or daily symptoms.
  
  
  CONCLUSIONS
  23% of Danish adults were using antacids or alginates and 14% were using PPI, of which one-half were on long-term therapy. Prescription renewal by phone or e-mail and use of other prescription medication were associated with long-term PPI use, indicating a behavioral pattern, in which unnecessary PPI therapy may be maintained.
authors.affiliation: Department of Medicine, Køge Hospital , Koege , Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Lødrup
authors.forename: Christina
authors.initials: C
authors.lastname: Reimer
authors.forename: Peter
authors.initials: P
authors.lastname: Bytzer
mesh_terms: D000367:Age Factors; D000464:Alginates / Q000627:therapeutic use*; D000863:Antacids / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003718:Denmark; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination / Q000706:statistics & numerical data; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D000464:Alginates; D000863:Antacids; D054328:Proton Pump Inhibitors
keywords: alginate; antacid; dyspepsia; general population; internet panel; over-the-counter medicine; proton pump inhibitor; reflux