title: Fewer acute respiratory infection episodes among patients receiving treatment for gastroesophageal reflux disease.
abstract: Patients with gastroesophageal reflux disease (GERD) present with comorbid complications with implications for healthcare utilization. To date, little is known about the effects of GERD treatment with a proton-pump inhibitor (PPI) on patients' subsequent healthcare utilization for acute respiratory infections (ARIs). This population-based study compared ARI episodes captured through outpatient visits, one year before and one year after GERD patients received PPI treatment. We used retrospective data from the Longitudinal Health Insurance Database 2005 in Taiwan, comparing 21,486 patients diagnosed with GERD from 2010 to 2012 with 21,486 age-sex matched comparison patients without GERD. Annual ARI episodes represented by ambulatory care visits for ARI (visits during a 7-day period bundled into one episode), were compared between the patient groups during the 1-year period before and after the index date (date of GERD diagnosis for study patients, first ambulatory visit in the same year for their matched comparison counterpart). Multiple regression analysis using a difference-in-difference approach was performed to estimate the adjusted association between GERD treatment and the subsequent annual ARI rate. We found that the mean annual ARI episode rate among GERD patients reduced by 11.4%, from 4.39 before PPI treatment, to 3.89 following treatment (mean change = -0.5 visit, 95% confidence interval (CI) = (-0.64, -0.36)). In Poisson regression analysis, GERD treatment showed an independent association with the annual ARI rate, showing a negative estimate (with p<0.001). The study suggests that GERD treatment with PPIs may help reduce healthcare visits for ARIs, highlighting the importance of treatment-seeking by GERD patients and compliance with treatment.
authors.affiliation: School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.|Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Herng-Ching
authors.initials: HC
authors.lastname: Lin
authors.affiliation: Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, United States of America.
authors.forename: Sudha
authors.initials: S
authors.lastname: Xirasagar
authors.affiliation: Department of Surgery, Far Eastern Memorial Hospital, Banciao, Taipei, Taiwan.
authors.forename: Shiu-Dong
authors.initials: SD
authors.lastname: Chung
authors.affiliation: School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chung-Chien
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Cathay General Hospital, Hsinchu Branch, Taiwan.
authors.forename: Ming-Chieh
authors.initials: MC
authors.lastname: Tsai
authors.affiliation: Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.|Department & Institute of Physiology, National Yang-Ming University, Taipei, Taiwan.|Department of Cosmetic Applications and Management, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.|Department of Thoracic Surgery, MacKay Memorial Hospital, Taipei, Taiwan.
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D015897:Comorbidity; D016208:Databases, Factual; D004198:Disease Susceptibility; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012044:Regression Analysis; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D054328:Proton Pump Inhibitors