A prospective study of dyspepsia in primary care

Dyspepsia is a common complaint, but its course and associated resource utilization have not been well described. In this study, 288 adult, primary care patients with dyspepsia treated at ambulatory clinics were followed prospectively for one year. Medical chart, utilization, and baseline and one-year follow-up survey data were collected. These patients had 13.3 medical visits (sex- and age-standardized) during the follow-up period, 55% above standardized mean visits for a comparison group of nondyspepsia patients. Standardized mean charges of $3542 for dyspeptics was 126% above nondyspepsia patient charges. Over half had gastrointestinal-related follow-up visits; 61% used gastrointestinal drugs; and 43% had gastrointestinal procedures. NSAID users had higher gastrointestinal-related utilization than did nonusers, recording an additional gastrointestinal visit (P < 0.001) and $678 more in charges (P = 0.03). Eighty-six percent of the 189 follow-up survey respondents experienced gastrointestinal symptoms at some time during the follow-up year. This study showed that most primary care dyspepsia patients remained symptomatic after one year and were intensive users of medical care.