Optimal Omeprazole Dosing and Symptom Control: A Randomized Controlled Trial (OSCAR Trial).

Area of Science:

• Gastroenterology
• Pharmacology
• Health Economics

Background:

• Proton pump inhibitors (PPIs) are primary treatments for gastroesophageal reflux disease (GERD).
• Suboptimal PPI dosing is common and negatively impacts symptom control.
• Previous studies have not evaluated the benefits of correcting PPI dosing regimens.

Purpose of the Study:

• To assess if optimizing omeprazole dosing improves GERD symptom control in patients with persistent symptoms.
• To evaluate the economic impact of suboptimal PPI use in GERD patients.

Main Methods:

• Patients with persistent heartburn (≥3 times/week) on omeprazole 20 mg daily were randomized.
• Intervention groups received either commonly recommended dosing or continued suboptimal dosing.
• Symptom changes were measured using the Gastroesophageal Reflux Disease Symptom Assessment Scale (GSAS) after 4 weeks.

Main Results:

• Optimized PPI dosing led to significant improvements in overall and heartburn-specific symptoms (P<0.01).
• Cost savings were estimated at $159.60 per patient, with potential annual savings exceeding $4 billion in the USA.
• Reduced medical care and workplace absenteeism contributed to cost savings.

Conclusions:

• Promoting adherence to recommended PPI dosing is a low-cost strategy to significantly reduce GERD symptoms.
• Correcting PPI dosing regimens offers substantial economic benefits by lowering healthcare costs and improving productivity.