PMID- 22519917
OWN - NLM
STAT- MEDLINE
DCOM- 20121031
LR  - 20120608
IS  - 1502-7708 (Electronic)
IS  - 0036-5521 (Linking)
VI  - 47
IP  - 7
DP  - 2012 Jul
TI  - Gastroesophageal reflux disease in primary care: using changes in proton pump 
      inhibitor therapy as an indicator of partial response.
PG  - 751-61
LID - 10.3109/00365521.2012.679682 [doi]
AB  - OBJECTIVE: Up to one-third of patients with gastroesophageal reflux disease 
      (GERD) in primary care have residual symptoms despite proton pump inhibitor (PPI) 
      therapy. We aimed to characterize partial response to PPIs among adult patients 
      in UK primary care. MATERIAL AND METHODS: Newly diagnosed GERD patients aged 
      20-79 years who were prescribed PPI for treatment of GERD were identified in The 
      Health Improvement Network. Those with a treatment change suggesting partial 
      response to PPIs (new treatment added to PPI, increased PPI dose, or switching 
      PPI) during the subsequent 6 months were identified as potential cases and 
      confirmed after manual review of each patient's complete computer medical record 
      including free-text comments. Patients without these treatment changes were study 
      controls. A nested case-control analysis was conducted using logistic regression. 
      RESULTS: The proportion of newly diagnosed GERD patients with partial response to 
      PPI therapy was 18.6% (1201/6453). Partial response was associated with female 
      gender (odds ratio [OR]: 1.20; 95% confidence interval [CI]: 1.05-1.37), anxiety 
      or depression (OR: 1.15; 95% CI: 1.00-1.31), and prescription of >/= 6 drugs in the 
      month before GERD diagnosis (OR: 1.42; 95% CI: 1.14-1.78). Among new PPI users (n 
      = 2907), partial response was associated with esophageal ulcer or Barrett's 
      esophagus at initial diagnosis (OR: 3.14; 95% CI: 1.60-6.17). CONCLUSIONS: 
      Approximately one in five newly diagnosed patients with GERD appear to have a 
      partial response to PPI therapy. Female gender, polymedication, and a severe 
      initial diagnosis may be associated with partial response.
FAU - Ruigomez, Ana
AU  - Ruigomez A
AD  - Spanish Centre for Pharmacoepidemiologic Research-CEIFE, Madrid, Spain. 
      aruigomez@ceife.es
FAU - Johansson, Saga
AU  - Johansson S
FAU - Wernersson, Borje
AU  - Wernersson B
FAU - Fernandez Cantero, Oscar
AU  - Fernandez Cantero O
FAU - Garcia Rodriguez, Luis A
AU  - Garcia Rodriguez LA
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120423
PL  - England
TA  - Scand J Gastroenterol
JT  - Scandinavian journal of gastroenterology
JID - 0060105
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anxiety/epidemiology
MH  - Barrett Esophagus/*drug therapy/etiology
MH  - Case-Control Studies
MH  - Comorbidity
MH  - Confidence Intervals
MH  - Depression/epidemiology
MH  - Drug Prescriptions
MH  - Electronic Health Records
MH  - Esophagitis, Peptic/*drug therapy/etiology
MH  - Esophagus
MH  - Female
MH  - Gastroesophageal Reflux/*drug therapy/epidemiology
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Primary Health Care
MH  - Proton Pump Inhibitors/administration & dosage/*therapeutic use
MH  - Sex Factors
MH  - Treatment Outcome
MH  - Ulcer/*drug therapy/etiology
MH  - Young Adult
EDAT- 2012/04/24 06:00
MHDA- 2012/11/01 06:00
CRDT- 2012/04/24 06:00
PHST- 2012/04/24 06:00 [entrez]
PHST- 2012/04/24 06:00 [pubmed]
PHST- 2012/11/01 06:00 [medline]
AID - 10.3109/00365521.2012.679682 [doi]
PST - ppublish
SO  - Scand J Gastroenterol. 2012 Jul;47(7):751-61. doi: 10.3109/00365521.2012.679682. 
      Epub 2012 Apr 23.