Initial proton pump inhibitor characteristics associated with long‐term prescriptions in US veterans diagnosed with gastro‐oesophageal reflux disease. Issue 3 (22nd May 2014)

• Record Type: Journal Article
• Authors: Gawron, Andrew J.; Pandolfino, John; Miskevics, Scott; LaVela, Sherri L.
• Is Part Of: Journal of pharmaceutical health services research. Volume 5:Issue 3(2014:Sep.)
• Page Start: 157
• Page End: 164
• Publication Date: 2014-05-22
• Subjects: Pharmacy -- Research -- Periodicals; Drugs -- Research -- Periodicals; Medical care -- Research -- Periodicals; Public health -- Research -- Periodicals; Pharmaceutical industry -- Periodicals; Health Services Research -- Periodicals; Economics, Pharmaceutical -- Periodicals; 615.1072
• DOI: 10.1111/jphs.12057
• Languages: English
• ISSNs: 1759-8885

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jphs12057-sec-0001" sec-type="section"> <title>Objectives</title> <p>The objectives were to (1) determine initial proton pump inhibitor (PPI) prescriptions in US veterans diagnosed with gastro‐oesophageal reflux disease (GERD); (2) assess initial PPI prescription factors associated with long‐term PPI prescriptions at the national level; (3) determine healthcare use in patients with short‐ and long‐term PPI prescriptions.</p> </sec> <sec id="jphs12057-sec-0002" sec-type="section"> <title>Methods</title> <p>US veterans aged 18–90 years with a clinical outpatient diagnosis of GERD from 2003 to 2007 were eligible for the study. Analyses assessed differences in prescribing patterns and healthcare use by PPI prescription duration (short term (<6 months) versus long term (≥6 months to 2 years)). Multivariable logistic regression was used to determine the initial prescription factors associated with long‐term PPI prescriptions adjusted for demographic and clinical characteristics.</p> </sec> <sec id="jphs12057-sec-0003" sec-type="section"> <title>Key findings</title> <p>A majority of patients with GERD and initial PPI prescriptions (<italic>n</italic> = 177 394) were classified as having long‐term PPI prescriptions (77.5%). A minority of patients received initial high daily dose prescriptions, and this differed slightly between short (18.3%) and long (16.2%) prescriptions (<italic>P</italic> < 0.0001). More patients received ≥90‐day initial supply of medication in those patients classified with long‐term prescriptions (71.4% versus 58.7%, <italic>P</italic> < 0.0001). Patients who provided a ≥90‐day total supply of the initial prescription were more likely to be dispensed PPIs long term (odds ratio 1.71; 95% CI, 1.67 to 1.76) when adjusted for patient demographic and clinical characteristics. Patients with long‐term PPI prescriptions had more overall healthcare encounters, predominantly of primary care origin.</p> </sec> <sec id="jphs12057-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The quantity of initial PPI prescriptions provided to Veterans does not reflect the guideline recommendations for GERD management and could affect long‐term use of these pervasive medications.</p> </sec> </abstract>