title: How Do US Gastroenterologists Use Over-the-Counter and Prescription Medications in Patients With Gastroesophageal Reflux and Chronic Constipation?
abstract: BACKGROUND
  The aim of this study was to assess how US gastroenterologists perceive and utilize over-the-counter (OTC) and prescription medications for gastroesophageal reflux disease (GERD) and chronic constipation (CC).
  
  
  METHODS
  A total of 3,600 randomly selected American Gastroenterological Association (AGA) members were mailed a 27-question survey that assessed their perceptions and use of OTC and prescription medications. The χ(2) test and Student's t-test were utilized for bivariate analysis.
  
  
  RESULTS
  A total of 830 gastroenterologists (23.1%) completed the survey. For the typical acid reflux patient, 50% of gastroenterologists recommended OTC proton pump inhibitors (PPIs), 13% recommended an OTC histamine2 receptor antagonist, whereas 33% recommended a prescription PPI. However, in the typical CC patient, 97% of gastroenterologists initially utilized OTC treatments. The vast majority of gastroenterologists felt that OTC brand name and store brand PPIs (76%) and polyethylene glycol (PEG 3350; 90%) were equally effective. Despite this, a minority "always" or "very often" directed their patients to purchase a store brand PPI (35%) or laxative (40%). In addition, gastroenterologists tended to underestimate the cost savings associated with store brand medicines and had limited knowledge regarding the regulation of store brands.
  
  
  CONCLUSIONS
  Among US gastroenterologists, OTC medications now dominate primary therapy of GERD and CC. Despite feeling that name brand and store brand PPIs and laxatives are equally effective, the majority of gastroenterologists recommend brand name medicines and underestimate the cost savings associated with store brands. In this age of accountable care, greater efforts to help physicians and patients to better utilize their health-care dollars is warranted.
authors.affiliation: Division of Gastroenterology, University of Michigan Health System, Ann Arbor, Michigan, USA.|Division of Gastroenterology, Ann Arbor Veterans' Administration Hospital, Ann Arbor, Michigan, USA.
authors.forename: Stacy B
authors.initials: SB
authors.lastname: Menees
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Guentner
authors.affiliation: Division of Gastroenterology, University of Michigan Health System, Ann Arbor, Michigan, USA.
authors.forename: Samuel W
authors.initials: SW
authors.lastname: Chey
authors.affiliation: Division of Gastroenterology, University of Michigan Health System, Ann Arbor, Michigan, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Saad
authors.affiliation: Division of Gastroenterology, University of Michigan Health System, Ann Arbor, Michigan, USA.
authors.forename: William D
authors.initials: WD
authors.lastname: Chey
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002400:Cathartics / Q000627:therapeutic use; D002908:Chronic Disease; D003248:Constipation / Q000188:drug therapy*; D017046:Cost Savings; D004043:Dietary Fiber / Q000627:therapeutic use; D019587:Dietary Supplements; D016568:Drugs, Generic / Q000191:economics / Q000627:therapeutic use; D005260:Female; D005762:Gastroenterology / Q000706:statistics & numerical data*; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use; D007880:Legislation, Drug; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000191:economics / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055553:Prescription Drugs / Q000627:therapeutic use; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D014481:United States
chemical_list: D002400:Cathartics; D004043:Dietary Fiber; D016568:Drugs, Generic; D006635:Histamine H2 Antagonists; D054368:Laxatives; D004366:Nonprescription Drugs; D055553:Prescription Drugs; D054328:Proton Pump Inhibitors; D011092:Polyethylene Glycols