Survey of prescriptions for peptic ulcer drugs (ACT class AOB2) in Iceland

The consumption of peptic ulcer drugs in Iceland is 20 DDD/1000/day, which is two to three times higher than in other Scandinavian countries. This study was done to register the pattern of use and possibly to find reasons for the high consumption.

Prescriptions for peptic ulcer drugs (ACT class AO2B) were surveyed in Iceland during 1 month in 1991. All pharmacies in Iceland participated in the study, and information was obtained on about 90% of peptic ulcer drugs used outside hospitals. The pharmacists registered all prescriptions of peptic ulcer drugs with regard to the age and sex of the patient, speciality of the prescribing physician, and name, dose, and quantity of the drug.

A total of 2021 prescriptions were registered, accounting for 15.4 DDD/1000/day. The prevalence of peptic ulcer drug use was 1.52%, but female use was 52.5%. The maximal use, 2.91% was in the age group 70-79 years. H2 blockers accounted for 79%, omeprazole for 17%, and other drugs for 4%. General practitioners prescribed 65% of the drugs, gastroenterologists 15%, and other specialists 14%. If the patient himself collected the drug, he was asked to fill out a questionnaire with regard to the reason for the prescription, previous prescriptions, and investigations. A total of 1131 (56%) of patient questionnaires were received. Only 1% of the patients did not know the reason for the prescription. The patients registered that 30% of the prescriptions were for peptic ulcer, 29% for heartburn, 21% for gastritis, 9% for dyspepsia, and 7% for prevention of side effects of other drugs. It was estimated from the data that about 40% of the prescriptions were for non-ulcer dyspepsia. Investigations were done in 67% of the patients, but 33% received the prescription only after an appointment with a physician.

The results of the survey suggest that the extensive use of peptic ulcer drugs in Iceland is mostly due to excessive use in non-ulcer dyspepsia.