Morales Suárez-Varela M M, Pérez-Benajas M A, Girbes Pelechano V J, Llopis-González A
Unit of Public Health, Hygiene and Environmental Care, Faculty of Pharmacy, University of Valencia, Dr. Peset Hospital, Spain.
Eur J Epidemiol. 1998 Jun;14(4):363-72. doi: 10.1023/a:1007493003891.
A study is made of the pharmaco-epidemiology of antacid (ATC class A02A) and antiulcer (A02B) drug prescriptions during the year 1992.
Prescription data were extracted from 1941 case histories of patients over 15 years old from four health care centers in the Valencian Community (Spain). Dosage and treatment duration were evaluated, along with the way in which morbidity, self-evaluated health, the demographic pattern and life-style characteristics influence drug prescription.
The proportion of drug prescriptions increased with age in both sexes (p < 0.01). Drug use depended mainly on chronic diseases. In prescribing antacids, the most influential diagnosis was gastritis (ICD 534, OR: 157), followed by duodenal ulcer (ICD 532, OR: 152) and gastric ulcer (ICD 531, OR: 122), other gastrointestinal disorders (ICD 66, OR: 54) and undefined diagnoses (OR: 15). In the prescription of antiulcer drugs, the most influential diagnoses were gastric and duodenal ulcer (OR: 380 and 342, respectively), and a significant relation was observed with the diagnosis of osteomuscular diseases (OR: 6). Lifestyle and demographic pattern were of marginal importance. The estimated duration of treatment was 85 days. No significant differences were observed in either treatment duration or administered doses of almagate, ranitidine and omeprazole with respect to sex, age or diagnosis.
Prolonged treatment is common for acid suppression. The widespread use of peptic ulcer drugs is mostly due to excessive prescription for non-ulcer dyspepsia. At the same time, many patients consume these drugs on a long-term basis in the absence of a clear diagnosis. This observation supports the need for appropriate diagnostic and prescription protocols to secure increased economical savings and management results.
对1992年抗酸剂（ATC分类A02A）和抗溃疡药物（A02B）处方的药物流行病学进行了研究。
从西班牙巴伦西亚自治区四个医疗保健中心1941例15岁以上患者的病历中提取处方数据。评估了剂量和治疗持续时间，以及发病率、自我评估的健康状况、人口统计学模式和生活方式特征对药物处方的影响方式。
两性的药物处方比例均随年龄增加（p < 0.01）。药物使用主要取决于慢性病。在开具抗酸剂时，最具影响力的诊断是胃炎（国际疾病分类534，比值比：157），其次是十二指肠溃疡（国际疾病分类532，比值比：152）和胃溃疡（国际疾病分类531，比值比：122）、其他胃肠道疾病（国际疾病分类66，比值比：54）和未明确诊断（比值比：15）。在抗溃疡药物处方中，最具影响力的诊断是胃溃疡和十二指肠溃疡（分别为比值比：380和342），并且观察到与骨肌肉疾病的诊断有显著关系（比值比：6）。生活方式和人口统计学模式的重要性较小。估计治疗持续时间为85天。在铝碳酸镁、雷尼替丁和奥美拉唑的治疗持续时间或给药剂量方面，未观察到性别、年龄或诊断之间的显著差异。
酸抑制的长期治疗很常见。消化性溃疡药物的广泛使用主要是由于对非溃疡性消化不良的过度处方。同时，许多患者在没有明确诊断的情况下长期服用这些药物。这一观察结果支持需要适当的诊断和处方方案，以确保提高经济节约和管理效果。
