Roberts S J, Bateman D N
Northern and Yorkshire Regional Drug and Therapeutics Centre, University of Newcastle, UK.
Aliment Pharmacol Ther. 1995 Apr;9(2):137-43. doi: 10.1111/j.1365-2036.1995.tb00362.x.
This study describes the pharmaco-epidemiology of ulcer-healing therapies in primary care in the north of England.
Anonymous patient-specific prescribing data were extracted from computerized general practice records for 41 practices. Prescribing prevalences were determined according to patient age, gender and recorded prescription indication, for both antacids and H2-receptor antagonists or omeprazole.
During the year of the study, antacids were prescribed for 3.9% of the study population, and H2-receptor antagonists or omeprazole for 3.7%. Rates increased with age, peaking at 99 (antacids) and 87 (H2-receptor antagonists) per 1000 population aged 65-84 years. Antacid prescribing rates for women were over twice those for men amongst those aged 15-34 years. For H2-receptor antagonists, rates were higher in men than women, with the excess attributable to prescribing for ulcer indications, although at all ages prescribing for oesophagitis was more prevalent among women. Of the patients prescribed H2-receptor antagonists or omeprazole, 45% (accounting for 51% of prescription items) had indications which included peptic ulcer or oesophagitis, 42% had gastritis or dyspepsia only (35% items), and in 13% no peptic indication was recorded. For each of antacids and H2-receptor antagonists, the practices had similar prescribing profiles according to patient age and gender, but their absolute levels differed up to two-fold.
Prescribing of antacids and ulcer-healing drugs varies systematically with patient age and gender. Consequently, evaluation of crude prescribing rates, without reference to patient demography, is unreliable as a guide to levels of usage. In general practice, H2-receptor antagonists and omeprazole appear to be over-prescribed for minor indications.
本研究描述了英格兰北部初级医疗中溃疡愈合疗法的药物流行病学情况。
从41家诊所的计算机化全科医疗记录中提取匿名的患者特定处方数据。根据患者年龄、性别以及记录的处方指征，确定抗酸剂和H2受体拮抗剂或奥美拉唑的处方患病率。
在研究年份，3.9%的研究人群使用了抗酸剂，3.7%使用了H2受体拮抗剂或奥美拉唑。使用率随年龄增长而增加，在65 - 84岁人群中达到峰值，每1000人中有99人使用抗酸剂，87人使用H2受体拮抗剂。在15 - 34岁人群中，女性抗酸剂处方率是男性的两倍多。对于H2受体拮抗剂，男性的使用率高于女性，这一差异主要归因于溃疡指征的处方，但在所有年龄段，食管炎的处方在女性中更为普遍。在使用H2受体拮抗剂或奥美拉唑的患者中，45%（占处方项目的51%）的指征包括消化性溃疡或食管炎，42%仅患有胃炎或消化不良（占项目的35%），13%未记录消化性指征。对于抗酸剂和H2受体拮抗剂，各诊所根据患者年龄和性别的处方情况相似，但绝对水平相差两倍。
抗酸剂和溃疡愈合药物的处方随患者年龄和性别而系统变化。因此，在不参考患者人口统计学特征的情况下评估粗略的处方率，作为使用水平的指南是不可靠的。在全科医疗中，H2受体拮抗剂和奥美拉唑对于轻微指征似乎存在过度处方的情况。
