Prescription of acid-suppressing drugs in relation to endoscopic diagnosis

a record-linkage study

A. T. Prach (Lead / Corresponding author), M. M. Mcgilchrist, F. E. Murray, D. A. Johnston, T. M. Macdonald

    Research output: Contribution to journalArticle

    6 Citations (Scopus)

    Abstract

    Background: Although widely used, few data are available on the appropriateness of prescribing of acid-suppressing drugs (ASDs), despite guidelines on the investigation and treatment of dyspeptic patients. Methods: We created a database of 62,000 endoscopy examinations and record-linked these to a prescribing database. Endoscopic diagnoses were classified into peptic, nonpeptic and others. The H2-antagonists, omeprazole and misoprostol, were studied. ResuIts: 35,000 patients had one or more endoscopies during 1978-93; two-thirds were over 45 years of age at first endoscopy. A quarter of all patients who had been endoscoped had consistently normal examinations. Peptic oesophageal pathology was the commonest positive finding. A quarter of those prescribed ASDs between 1989 and 1993 had been endoscoped between 1978 and 1993. In those with a peptic diagnosis prescribed any ASD, the pathologies found were: oesophageal (42.9%), duodenal (36.3%) and gastropyloric (21.3%). Patients prescribed omeprazole were more likely to have undergone endoscopy than those prescribed other ASDs, and they were also more likely to have peptic oesophageal pathology. Long-term prescribing (> 56 days per year) occurred in two-thirds of patients prescribed ASDs and 40% had at least one endoscopy. In those prescribed short-term ASDs, 20% had undergone at least one endoscopy. Peptic and nonpeptic endoscopic pathology was associated with increased ASD prescribing, but a normal endoscopy did not reduce prescribing. Conclusion: ASD prescribing appeared to be mainly symptom-driven. Positive endoscopic findings increased the prescribing of ASDs, but normal findings did not reduce it.

    Original languageEnglish
    Pages (from-to)397-405
    Number of pages9
    JournalAlimentary Pharmacology and Therapeutics
    Volume13
    Issue number3
    DOIs
    Publication statusPublished - Mar 1999

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    Prescriptions
    Endoscopy
    Acids
    Digestion
    Pharmaceutical Preparations
    Pathology
    Drug Prescriptions
    Omeprazole
    Databases
    Misoprostol
    Guidelines

    Cite this

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    title = "Prescription of acid-suppressing drugs in relation to endoscopic diagnosis: a record-linkage study",
    abstract = "Background: Although widely used, few data are available on the appropriateness of prescribing of acid-suppressing drugs (ASDs), despite guidelines on the investigation and treatment of dyspeptic patients. Methods: We created a database of 62,000 endoscopy examinations and record-linked these to a prescribing database. Endoscopic diagnoses were classified into peptic, nonpeptic and others. The H2-antagonists, omeprazole and misoprostol, were studied. ResuIts: 35,000 patients had one or more endoscopies during 1978-93; two-thirds were over 45 years of age at first endoscopy. A quarter of all patients who had been endoscoped had consistently normal examinations. Peptic oesophageal pathology was the commonest positive finding. A quarter of those prescribed ASDs between 1989 and 1993 had been endoscoped between 1978 and 1993. In those with a peptic diagnosis prescribed any ASD, the pathologies found were: oesophageal (42.9{\%}), duodenal (36.3{\%}) and gastropyloric (21.3{\%}). Patients prescribed omeprazole were more likely to have undergone endoscopy than those prescribed other ASDs, and they were also more likely to have peptic oesophageal pathology. Long-term prescribing (> 56 days per year) occurred in two-thirds of patients prescribed ASDs and 40{\%} had at least one endoscopy. In those prescribed short-term ASDs, 20{\%} had undergone at least one endoscopy. Peptic and nonpeptic endoscopic pathology was associated with increased ASD prescribing, but a normal endoscopy did not reduce prescribing. Conclusion: ASD prescribing appeared to be mainly symptom-driven. Positive endoscopic findings increased the prescribing of ASDs, but normal findings did not reduce it.",
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    Prescription of acid-suppressing drugs in relation to endoscopic diagnosis : a record-linkage study. / Prach, A. T. (Lead / Corresponding author); Mcgilchrist, M. M.; Murray, F. E.; Johnston, D. A.; Macdonald, T. M.

    In: Alimentary Pharmacology and Therapeutics, Vol. 13, No. 3, 03.1999, p. 397-405.

    Research output: Contribution to journalArticle

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