Mishuk Ahmed Ullah, Chen Li, Gaillard Philippe, Westrick Salisa, Hansen Richard A, Qian Jingjing
J Am Pharm Assoc (2003). 2020 Oct 22. doi: 10.1016/j.japh.2020.09.015.
In the United States, proton pump inhibitors (PPIs) are one of the most commonly prescribed classes of drugs, but contemporary data on national-level utilization patterns for PPI use are limited. This study examined the trends in prescription PPI use and expenditures, overall and by patient subgroups, and identified predictors of PPI use.
Prescription PPI use was identified from the 2002-2017 Medical Expenditure Panel Survey data using the brand and generic names. Trends in PPI use were examined overall and by patients' sociodemographic characteristics and disease status. Trends in brand and generic PPI users and total and average PPI expenditures were also examined. A multivariable model was used to identify patient factors associated with PPI use.
The overall proportion of PPI users increased from 5.70% in 2002-2003 to 6.73% in 2016-2017 (P value = 0.011). Increased trends in PPI use were observed among U.S. adults aged 65 years and older, both males and females, non-Hispanic whites, non-Hispanic blacks, Hispanics, Asians, in all 4 geographic regions, with public health insurance, and those who were obese (all P value < 0.05). Whereas PPI use increased significantly, the average PPI expenditure per patient decreased significantly. Multivariable results found that participants who were aged 25 years or older, were female, were non-Hispanic whites, resided in the Northeast, had higher incomes, had public or private health insurance, were obese, were married had a higher likelihood of using PPIs.
Increased PPI use was observed among most of the patient subgroups. Understanding the utilization patterns of PPIs could help practitioners identify potential treatment disparities and monitor the safety of PPI use.
在美国，质子泵抑制剂（PPI）是最常被处方的药物类别之一，但关于全国范围内PPI使用模式的当代数据有限。本研究调查了处方PPI使用和支出的趋势，包括总体趋势以及按患者亚组划分的趋势，并确定了PPI使用的预测因素。
使用品牌名和通用名从2002 - 2017年医疗支出面板调查数据中识别处方PPI的使用情况。总体上以及按患者的社会人口统计学特征和疾病状态研究PPI使用趋势。还研究了品牌和通用PPI使用者的趋势以及PPI总支出和平均支出。使用多变量模型确定与PPI使用相关的患者因素。
PPI使用者的总体比例从2002 - 2003年的5.70%增至2016 - 2017年的6.73%（P值 = 0.011）。在美国65岁及以上的成年人中，无论男女，非西班牙裔白人、非西班牙裔黑人、西班牙裔、亚裔，在所有4个地理区域，有公共医疗保险的人群以及肥胖者中，均观察到PPI使用呈上升趋势（所有P值 < 0.05）。虽然PPI使用显著增加，但每位患者的平均PPI支出显著下降。多变量结果发现，年龄在25岁及以上、女性、非西班牙裔白人、居住在东北部、收入较高、有公共或私人医疗保险、肥胖、已婚的参与者使用PPI的可能性更高。
在大多数患者亚组中观察到PPI使用增加。了解PPI的使用模式有助于从业者识别潜在的治疗差异并监测PPI使用的安全性。
