Persistence and adherence to proton pump inhibitors in daily clinical practice
Version of Record online: 26 JUN 2006
Alimentary Pharmacology & Therapeutics
Volume 24, Issue 2, pages 377–385, July 2006
How to Cite
VAN SOEST, E. M., SIERSEMA, P. D., DIELEMAN, J. P., STURKENBOOM, M. C. J. M. and KUIPERS, E. J. (2006), Persistence and adherence to proton pump inhibitors in daily clinical practice. Alimentary Pharmacology & Therapeutics, 24: 377–385. doi: 10.1111/j.1365-2036.2006.02982.x
- Issue online: 26 JUN 2006
- Version of Record online: 26 JUN 2006
- Publication data Submitted 6 April 2006 First decision 1 May 2006 Resubmitted 3 May 2006 Accepted 3 May 2006
Proton pump inhibitors are widely used, but little is known about the usage pattern in different indications.
To analyse proton pump inhibitor usage patterns in the general population.
A cohort of 16 311 incident proton pump inhibitor users was identified in the Integrated Primary Care Information database, a Dutch general practice research database. Persistence and adherence were calculated by indication. Risk factors were identified by logistic regression analysis.
One-year persistence was 31% in patients using proton pump inhibitors for gastro-oesophageal reflux. Persistence was higher in oesophagitis grade A/B (54%), grade C/D (73%) and Barrett's oesophagus (72%), compared to patients with only reflux symptoms (27%). Approximately 25% of patients with non-reflux dyspepsia or Helicobacter pylori-associated indications used proton pump inhibitors for more than 6 months. Half of all patients used proton pump inhibitors <80% of time indicating intermittent use, which was independent of indication. Exception were patients with Barrett's oesophagus, who were most adherent.
A substantial proportion of patients with indications not requiring long-term treatment use proton pump inhibitors for an extended period. Half of the patients used proton pump inhibitors on-demand or intermittently. Such usage pattern is probably sufficient for most patients, but may be inadequate if proton pump inhibitors are used for serious diseases, such as severe oesophagitis or Barrett's oesophagus.