Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
Epidemiology and Public Health Networking Biomedical Research Centre (CIBERESP), Madrid, Spain.
Basic Clin Pharmacol Toxicol. 2019 Jun;124(6):704-710. doi: 10.1111/bcpt.13191. Epub 2019 Jan 20.
Proton pump inhibitors (PPI) are among the most frequently used drugs in the developed countries. In recent years, their use among children and adolescents has been on the increase. Guidelines recommend use for a period no longer than 4-8 weeks. The aim of this study was to describe time trends in prescribing patterns of PPI use among children, with emphasis on persistence to therapy.
We used the Danish nationwide healthcare registries and identified all Danish children (0-17 years old) who were provided with a filled in PPI prescription between 2000 and 2015. Based on descriptive analyses, we reported trends over time in annual use, prevalent and incident users. Moreover, we evaluated persistence to treatment and doses used over time. Analyses were stratified by age groups (0-4, 5-11 and 12-17 years).
We identified 212 056 filled in PPI prescriptions prescribed to 78 489 children. The total annual use of PPIs among children increased eight times from 2000 to 2015. Omeprazole was most frequently used (60% of all use). The proportion of prevalent users increased from 0.1 in 2000 to 3.1 per 1000 children in 2015, while the rate of new users increased from 1.2 to 8.0 per 1000 child years. In general, persistence to PPIs was low: in the youngest age groups (14%), slightly more children were covered by treatment 12 months after the first prescription compared with the oldest age groups (5%).
The use of PPIs among Danish children has increased substantially during the last 15 years. In general, treatment with PPIs among children was of short duration. Attention should be paid to indications and rationality behind initiation of therapy.
质子泵抑制剂 (PPI) 是发达国家最常用的药物之一。近年来,儿童和青少年中 PPI 的使用呈上升趋势。指南建议使用时间不超过 4-8 周。本研究的目的是描述儿童 PPI 使用的处方模式随时间的变化趋势,重点是治疗的持续性。
我们使用丹麦全国性医疗保健登记处,确定了 2000 年至 2015 年期间所有接受 PPI 处方的丹麦儿童(0-17 岁)。基于描述性分析,我们报告了年度使用、现患用户和新发用户随时间的变化趋势。此外,我们评估了治疗的持续性和随时间变化的剂量。分析按年龄组(0-4、5-11 和 12-17 岁)分层。
我们确定了 212056 份 PPI 处方,用于 78489 名儿童。2000 年至 2015 年,儿童 PPI 的总年使用量增加了 8 倍。奥美拉唑的使用率最高(占所有使用量的 60%)。现患用户的比例从 2000 年的 0.1 增加到 2015 年的每 1000 名儿童 3.1 人,而新用户的比例从每 1000 名儿童 1.2 人增加到 8.0 人。一般来说,PPI 的治疗持续性较低:在年龄最小的组(14%)中,与年龄最大的组(5%)相比,首次处方后 12 个月内接受治疗的儿童略多。
在过去 15 年中,丹麦儿童使用 PPI 的情况大幅增加。总的来说,儿童使用 PPI 的治疗时间较短。应注意治疗启动的适应症和合理性。