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Published on: February 21, 2019
Use of proton pump inhibitors among Danish children: A 16-year register-based nationwide study
Ignacio Aznar-Lou1,2,3, Mette Reilev3,4, Anders Bergh Lødrup5,6
1Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
Insights
Proton pump inhibitor (PPI) use in Danish children rose significantly from 2000-2015, with most treatments being short-term. Further review of PPI prescription indications is recommended.
Area of Science:
- Pediatric Pharmacology
- Drug Utilization Studies
- Public Health
Background:
- Proton pump inhibitors (PPIs) are widely prescribed, with increasing use in pediatric populations.
- Established guidelines recommend short-term PPI therapy (4-8 weeks) for children and adolescents.
- Understanding prescribing patterns and treatment duration is crucial for appropriate pediatric care.
Purpose of the Study:
- To analyze time trends in proton pump inhibitor (PPI) prescribing patterns among children in Denmark.
- To investigate the persistence of PPI therapy in pediatric patients.
- To identify trends in PPI use stratified by age groups.
Main Methods:
- Utilized Danish nationwide healthcare registries to identify PPI prescriptions for children aged 0-17 years (2000-2015).
- Conducted descriptive analyses of annual use, prevalent users, and incident users.
- Evaluated treatment persistence and dosage trends, stratified by age (0-4, 5-11, 12-17 years).
Main Results:
- Total annual PPI use in children increased eightfold between 2000 and 2015.
- Prevalent users increased from 0.1 to 3.1 per 1000 children, and new users from 1.2 to 8.0 per 1000 child-years.
- Treatment persistence was generally low, with only 14% of the youngest and 5% of the oldest children covered 12 months post-prescription.
Conclusions:
- Substantial increase in PPI utilization among Danish children over 15 years.
- Pediatric PPI therapy is typically of short duration.
- Need for careful consideration of indications and rationale for initiating PPI therapy in children.
Objectives:
Proton pump inhibitors (PPI) are among the most frequently used drugs in the developed countries. In recent years, their use among children and adolescents has been on the increase. Guidelines recommend use for a period no longer than 4-8 weeks. The aim of this study was to describe time trends in prescribing patterns of PPI use among children, with emphasis on persistence to therapy.
Methods:
We used the Danish nationwide healthcare registries and identified all Danish children (0-17 years old) who were provided with a filled in PPI prescription between 2000 and 2015. Based on descriptive analyses, we reported trends over time in annual use, prevalent and incident users. Moreover, we evaluated persistence to treatment and doses used over time. Analyses were stratified by age groups (0-4, 5-11 and 12-17 years).
Results:
We identified 212 056 filled in PPI prescriptions prescribed to 78 489 children. The total annual use of PPIs among children increased eight times from 2000 to 2015. Omeprazole was most frequently used (60% of all use). The proportion of prevalent users increased from 0.1 in 2000 to 3.1 per 1000 children in 2015, while the rate of new users increased from 1.2 to 8.0 per 1000 child years. In general, persistence to PPIs was low: in the youngest age groups (14%), slightly more children were covered by treatment 12 months after the first prescription compared with the oldest age groups (5%).
Conclusion:
The use of PPIs among Danish children has increased substantially during the last 15 years. In general, treatment with PPIs among children was of short duration. Attention should be paid to indications and rationality behind initiation of therapy.
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