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The use of long-term acid-suppression therapy
G P Rubin1, B Contractor, M G Bramble
1Thornaby Health Centre, Middlesbrough.
The British Journal of Clinical Practice
|May 1, 1995
Summary
Long-term acid suppression therapy for dyspepsia is common, especially in older adults. Many patients on this treatment lack a clear diagnosis, with duodenal ulcers being the most frequent finding.
Area of Science:
- Gastroenterology
- Pharmacology
- Primary Healthcare Research
Background:
- Acid suppression therapy is widely prescribed for dyspepsia, often for extended durations.
- Long-term use necessitates an audit to assess prescribing patterns and patient outcomes.
- Understanding the indications and diagnoses for prolonged acid suppression is crucial for optimizing patient care.
Purpose of the Study:
- To audit the use of long-term acid suppression therapy in primary care.
- To identify patient demographics, diagnoses, and co-prescriptions (e.g., NSAIDs) associated with long-term therapy.
- To evaluate the diagnostic yield for dyspepsia in patients receiving prolonged acid suppression.
Main Methods:
- Retrospective audit of patients on long-term acid suppression therapy (>12 months) across two primary care practices.
- Identification of patients via computerized prescribing records for continuous and intermittent therapy.
- Scrutiny of patient records to determine diagnosis, therapy duration, and NSAID use.
Main Results:
- 365 patients were identified on long-term acid suppression therapy (233 continuous, 132 intermittent).
- 83% of patients were over 45 years old; 20% were concurrently using NSAIDs.
- Of 310 investigated patients, only 250 had a confirmed diagnosis, with duodenal ulcer being most common (154 cases).
Conclusions:
- Long-term acid suppression therapy is frequently prescribed in primary care, particularly for patients over 45.
- A significant proportion of patients on long-term therapy may not have a clear, confirmed diagnosis for their dyspepsia.
- The high prevalence of duodenal ulcers suggests this remains a key indication, but further investigation into appropriate long-term use is warranted.