Department of Medical Gastroenterology, Køge Hospital, Copenhagen University, Copenhagen, Denmark.
Aliment Pharmacol Ther. 2009 Oct;30(7):725-32. doi: 10.1111/j.1365-2036.2009.04092.x. Epub 2009 Jul 8.
The use of proton pump inhibitors (PPIs) is extensive. While the incidence of new treatments remains stable, the prevalence of long-term treatment is rising. Studies have shown that up to 70% of patients on chronic acid suppression lack a verified indication for treatment.
To investigate primary care patient characteristics associated with long-term use of PPIs.
A cross-sectional analysis of 42,634 patients registered with 22 general practitioners was performed. Patients with prescriptions of > or =120 tablets/year were defined as long-term users. A survey of a subgroup of patients without verified indication was performed.
In all, 901 (2.1%) patients were long-term treated. Verified indications for treatment were identified for 247/901 (27%). An upper GI endoscopy had been performed in 418 patients (46%). Of the 194/654 without verified indication who participated in the survey, 71% reported heartburn/acid regurgitation as the reason for therapy. On-demand therapy was reported by 43/194 (22%) and previous attempts to withdraw by 119/194 (61%).
The prevalence of PPI long-term treatment among primary care patients is 2.1%. The main reason for treatment is reflux symptoms or verified GERD. Rationalization of use of PPIs is possible as daily treatment without attempts to discontinue is frequently observed.
质子泵抑制剂（PPIs）的应用非常广泛。虽然新的治疗方法的发病率保持稳定，但长期治疗的患病率正在上升。研究表明，高达 70%的接受慢性酸抑制治疗的患者缺乏经证实的治疗指征。
调查与长期使用质子泵抑制剂相关的初级保健患者特征。
对 22 名全科医生登记的 42634 名患者进行了横断面分析。将每年处方>或=120 片的患者定义为长期使用者。对无经证实指征的患者亚组进行了调查。
共有 901 名（2.1%）患者接受了长期治疗。对 247/901 名（27%）患者的治疗指征进行了确认。418 名患者进行了上消化道内窥镜检查。在 194/654 名无经证实指征的患者中，有 71%的人报告烧心/胃酸反流是治疗的原因。有 43/194（22%）名患者报告按需治疗，有 119/194（61%）名患者报告以前曾试图停药。
初级保健患者中质子泵抑制剂长期治疗的患病率为 2.1%。治疗的主要原因是反流症状或经证实的 GERD。由于经常观察到无需停药的日常治疗，因此可以合理化质子泵抑制剂的使用。
