Repeat prescribing of ulcer healing drugs in general practice--prevalence and underlying diagnosis
B M Goudie1, P E McKenzie, J Cipriano
1Westgate Health Centre, Dundee, UK.
Background:
The long-term use of ulcer healing drugs in the management of dyspepsia is controversial. We have investigated repeat prescribing of these drugs in a general practice population.
Aims:
To identify the number of patients authorized to receive repeat prescriptions for ulcer healing drugs, and to review the investigation status and diagnosis in these patients.
Subjects:
A total of 15,495 patients registered with eight general practitioners in seven general practices in Dundee, UK.
Methods:
Case ascertainment by review of practice repeat prescribing registers. Data regarding investigation and diagnosis obtained by retrospective review of general practice case records.
Results:
Six hundred and seventy-nine (4.4% of the total population) were authorized to receive repeat prescriptions for ulcer healing drugs. Six hundred and fifty-one (4.2%) were authorized to receive repeat prescriptions for H2-antagonists. Ranitidine was prescribed in 583 (86% of patients receiving ulcer healing drugs). Endoscopy had been performed in 426 (63%) and barium meal alone in 113 (17%); 140 (21%) had not been investigated. A diagnosis of peptic ulcer disease or oesophagitis was established in 382 (56%). However, 157 investigated patients (23% of all patients on ulcer healing drugs) did not have a peptic diagnosis.
Conclusions:
The prevalence of repeat prescribing of ulcer healing drugs in the general practice population studied was 4.4%, but 44% of these patients did not have a confirmed diagnosis of acid peptic disease.
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