General practice variation in peptic ulcer prophylaxis: a nationwide register-based study

Area of Science:

• Gastroenterology
• Pharmacology
• General Practice

Background:

• Peptic ulcer bleeding incidence can be reduced with prophylactic proton pump inhibitors (PPIs).
• However, PPI use varies among at-risk patients, suggesting potential under-prescribing.
• The extent of this variation in general practice settings is not well understood.

Purpose of the Study:

• To analyze the proportion of high-risk patients receiving PPI prophylaxis in Danish general practices.
• To investigate associations between general practice characteristics and PPI prescribing for ulcer bleeding prevention.

Main Methods:

• Nationwide register-based cross-sectional study.
• Analysis of patients at risk of ulcer bleeding within Danish general practices.
• Logistic regression to examine practice characteristic associations with PPI treatment.

Main Results:

• Less than 40% of at-risk patients were covered by PPIs in most general practices.
• Geographical variations in PPI coverage were observed, with higher rates outside the capital.
• Older, female-dominated, and partnership practices showed higher PPI coverage compared to younger or male-dominated ones.

Conclusions:

• Significant under-prescribing of ulcer prophylaxis exists across various general practice types.
• Few practice characteristics were strongly associated with PPI prescribing patterns.
• New methods are needed to help general practitioners identify patients at risk for ulcer complications.