Reckitt Benckiser Healthcare UK Ltd., Slough, UK.
J Prim Care Community Health. 2022 Jan-Dec;13:21501319221088688. doi: 10.1177/21501319221088688.
Proton pump inhibitors (PPIs) used in the management of gastro-esophageal reflux disease (GORD) are among the most frequently prescribed classes of drug worldwide. Currently, however, physicians are prescribing PPIs for extended periods, often without an indication, which is not in line with current guidance and therefore preventing appropriate reflux management. Inappropriate or excessive PPI prescribing is becoming increasingly visible, yet there is currently little research available on the impact such current practice has on the patient experience. This study aims to understand patient attitudes toward their PPI treatment and the impact current PPI prescribing patterns have on the patient experience.
An online survey of current and previous users of PPI for GORD was conducted in the UK and Germany. Topics covered included prior steps taken before first consultation with a physician, initial recommendations, PPI treatment initiation and duration, use of PPI, management of reflux whilst taking a PPI, stopping PPI treatment, and patient attitudes.
Among 566 patient participants (UK, n = 372; Germany, n = 194) 69% to 79% reported being prescribed medication at their first visit to a physician, of which 61% to 68% were prescribed a PPI either alone or combined with another treatment. 41% to 48% of patients answered "don't know" when asked how long they expected to continue taking their PPI. 49% to 50% of patients currently on PPIs also reported having concerns with regards to long-term treatment. 70% of patients recalled being well informed on dosage and treatment regimens. However, other safety and usage information was reported as being less frequently discussed.
Although patients reported concerns regarding ongoing long-term PPI treatment, this was not reflected in the prescribing pattern from physicians. More can be done to ensure patients are fully informed about their PPI treatment at consultation. Findings also suggest a disconnect exists between standard treatment guidelines and prescribing patterns, as experienced by patients.
质子泵抑制剂(PPIs)用于治疗胃食管反流病(GORD),是全球应用最广泛的处方药物之一。然而,目前医生常常在没有明确指征的情况下开具 PPI 延长疗程,这不符合当前的指导原则,也妨碍了恰当的反流管理。不恰当或过度开具 PPI 的情况日益明显,但目前关于此类治疗方案对患者体验影响的研究较少。本研究旨在了解患者对 PPI 治疗的态度,以及当前 PPI 处方模式对患者体验的影响。
在英国和德国,对当前和以前使用 PPI 治疗 GORD 的患者进行了在线调查。涵盖的主题包括首次就诊前采取的措施、初始建议、PPI 治疗开始和持续时间、PPI 使用、服用 PPI 时的反流管理、停止 PPI 治疗以及患者态度。
在 566 名患者参与者中(英国,n=372;德国,n=194),69%至 79%的患者报告在首次就诊时被开具药物,其中 61%至 68%的患者单独或联合其他治疗方案开具了 PPI。41%至 48%的患者在被问及预计将继续服用 PPI 的时间时回答“不知道”。目前正在服用 PPI 的 49%至 50%的患者也对长期治疗表示担忧。70%的患者回忆说,他们对剂量和治疗方案有很好的了解。然而,其他安全性和使用信息的讨论频率较低。
尽管患者对长期服用 PPI 治疗表示担忧,但这并没有反映在医生的处方模式中。在就诊时,还可以做更多的工作以确保患者充分了解其 PPI 治疗。研究结果还表明,患者经历的标准治疗指南与处方模式之间存在脱节。