Martin R M, Lim A G, Kerry S M, Hilton S R
Division of General Practice and Primary Care, St George's Hospital Medical School, London, UK.
Aliment Pharmacol Ther. 1998 Aug;12(8):797-805. doi: 10.1046/j.1365-2036.1998.00374.x.
H2-receptor antagonists and proton pump inhibitors account for approximately 15% of primary care prescribing costs in the UK.
To examine the use of antisecretory drugs in primary care between October 1991 and September 1996.
Analysis of prescribing data from an ongoing postal survey performed every 3 months on a rolling quota of 250 UK general practitioners (GPs), identified from a representative sampling frame of 1000 GPs.
There were 8811 new courses of proton pump inhibitors and 11,948 new courses of H2-receptor antagonists during this study. The number of new prescriptions for proton pump inhibitors increased by 174.5%, but decreased for H2-receptor antagonists by 12.5%. Proton pump inhibitors were mostly prescribed for reflux disease (52.7%) and H2-receptor antagonists for non-specific dyspepsia (43.6%). Proton pump inhibitors (14.1%) were less likely to be stopped than H2-receptor antagonists (35.3%) overall, and they were less likely to be stopped because of perceived ineffectiveness (5.3%) than H2-receptor antagonists (23.8%). The rate of stopping treatment because of side-effects was about 3% for both classes of drug.
Prescribing of proton pump inhibitors has increased sharply each year since 1991. One reason may be that GPs perceive proton pump inhibitors to be more effective than H2-receptor antagonists.
在英国,H2受体拮抗剂和质子泵抑制剂约占基层医疗处方成本的15%。
研究1991年10月至1996年9月期间基层医疗中抗分泌药物的使用情况。
对一项正在进行的邮政调查的处方数据进行分析,该调查每3个月对250名英国全科医生(GP)进行一次滚动配额调查,这些全科医生从1000名全科医生的代表性抽样框架中确定。
在本研究期间,有8811个新的质子泵抑制剂疗程和11948个新的H2受体拮抗剂疗程。质子泵抑制剂的新处方数量增加了174.5%,而H2受体拮抗剂的新处方数量减少了12.5%。质子泵抑制剂大多用于治疗反流性疾病(52.7%),H2受体拮抗剂用于治疗非特异性消化不良(43.6%)。总体而言,质子泵抑制剂(14.1%)比H2受体拮抗剂(35.3%)停药的可能性更小,并且与H2受体拮抗剂(23.8%)相比,因认为无效而停药的可能性更小(5.3%)。两类药物因副作用而停药的比例约为3%。
自1991年以来,质子泵抑制剂的处方量每年都在急剧增加。一个原因可能是全科医生认为质子泵抑制剂比H2受体拮抗剂更有效。