PMID- 33293322
OWN - NLM
STAT- MEDLINE
DCOM- 20210326
LR  - 20210326
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 10
IP  - 12
DP  - 2020 Dec 7
TI  - Trends in acid suppressant drug prescriptions in primary care in the UK: a 
      population-based cross-sectional study.
PG  - e041529
LID - 10.1136/bmjopen-2020-041529 [doi]
LID - e041529
AB  - OBJECTIVE: To examine proton pump inhibitor (PPI) and histamine-2 receptor 
      antagonist (H2RA) prescribing patterns over a 29-year period by quantifying 
      annual prevalence and prescribing intensity over time. DESIGN: Population-based 
      cross-sectional study. SETTING: More than 700 general practices contributing data 
      to the UK Clinical Practice Research Datalink (CPRD). PARTICIPANTS: Within a 
      cohort of 14 242 329 patients registered in the CPRD, 3 027 383 patients were 
      prescribed at least one PPI or H2RA from 1 January 1990 to 31 December 2018. 
      PRIMARY AND SECONDARY OUTCOME MEASURES: Annual prescription rates were estimated 
      by dividing the number of patients prescribed a PPI or H2RA by the total CPRD 
      population. Change in prescribing intensity (number of prescriptions per year 
      divided by person-years of follow-up) was calculated using negative binomial 
      regression. RESULTS: From 1990 to 2018, 21.3% of the CPRD population was exposed 
      to at least one acid suppressant drug. During that period, PPI prevalence 
      increased from 0.2% to 14.2%, while H2RA prevalence remained low (range: 
      1.2%-3.4%). Yearly prescribing intensity to PPIs increased during the first 15 
      years of the study period but remained relatively constant for the remainder of 
      the study period. In contrast, yearly prescribing intensity of H2RAs decreased 
      from 1990 to 2009 but has begun to slightly increase over the past 5 years. 
      CONCLUSIONS: While PPI prevalence has been increasing over time, its prescribing 
      intensity has recently plateaued. Notwithstanding their efficacy, PPIs are 
      associated with a number of adverse effects not attributed to H2RAs, whose 
      prescribing intensity has begun to increase. Thus, H2RAs remain a valuable 
      treatment option for individuals with gastric conditions.
CI  - (c) Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Abrahami, Devin
AU  - Abrahami D
AD  - Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, 
      Montreal, Quebec, Canada.
AD  - Department of Epidemiology, Biostatistics, and Occupational Health, McGill 
      University, Montreal, Quebec, Canada.
FAU - McDonald, Emily Gibson
AU  - McDonald EG
AD  - Clinical Practice Assessment Unit, Department of Medicine, McGill University 
      Health Centre, Montreal, Quebec, Canada.
AD  - Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada.
FAU - Schnitzer, Mireille
AU  - Schnitzer M
AD  - Faculte de Pharmacie, Universite de Montreal, Montreal, Quebec, Canada.
FAU - Azoulay, Laurent
AU  - Azoulay L
AUID- ORCID: 0000-0001-5162-3556
AD  - Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, 
      Montreal, Quebec, Canada laurent.azoulay@mcgill.ca.
AD  - Department of Epidemiology, Biostatistics, and Occupational Health, McGill 
      University, Montreal, Quebec, Canada.
AD  - Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, 
      Canada.
LA  - eng
GR  - FDN-143328/CAPMC/CIHR/Canada
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20201207
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cross-Sectional Studies
MH  - *Drug Prescriptions
MH  - Female
MH  - *Histamine H2 Antagonists/therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Practice Patterns, Physicians'
MH  - Primary Health Care
MH  - *Proton Pump Inhibitors/therapeutic use
MH  - United Kingdom
MH  - Young Adult
PMC - PMC7722810
OTO - NOTNLM
OT  - epidemiology
OT  - gastroduodenal disease
OT  - primary care
COIS- Competing interests: None declared.
EDAT- 2020/12/10 06:00
MHDA- 2021/03/27 06:00
PMCR- 2020/12/07
CRDT- 2020/12/09 06:05
PHST- 2020/12/09 06:05 [entrez]
PHST- 2020/12/10 06:00 [pubmed]
PHST- 2021/03/27 06:00 [medline]
PHST- 2020/12/07 00:00 [pmc-release]
AID - bmjopen-2020-041529 [pii]
AID - 10.1136/bmjopen-2020-041529 [doi]
PST - epublish
SO  - BMJ Open. 2020 Dec 7;10(12):e041529. doi: 10.1136/bmjopen-2020-041529.