Proton pump inhibitor use in the U.S. ambulatory setting, 2002-2009.

Proton pump inhibitor use in the U.S. ambulatory setting, 2002-2009.
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质子泵抑制剂在美国门诊环境中的使用,2002-2009 年。

DOI:
10.1371/journal.pone.0056060
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发表时间:
2013
期刊:
影响因子:
3.7
通讯作者:
Bishop TF
Bishop TF
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Rotman SR;Bishop TF

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轶事报告和对选定人群的研究表明,质子泵抑制剂(PPI)的使用自引入以来有所增加。我们试图确定PPI在美国门诊使用的最新趋势,以及可能预测其使用的患者和医生的特征。我们使用来自全国门诊医疗调查(NAMCS)和全国医院门诊医疗调查(NHAMCS)的数据来估计2002年至2009年患者使用PPI的就诊率。我们使用2009年的数据测试了PPI使用与患者,医生和实践特征之间的关联。我们还估计了无胃肠道不适、诊断或其他使用适应症的患者使用PPI的访视的患病率,并检测了患者和医生特征与无记录适应症患者使用PPI之间的相关性。2002年4.0%的访视和2009年9.2%的访视使用了PPI(各年趋势p<0.001)。奥美拉唑(2002年0.9%至2009年3.9%,p<0.001)、埃索美拉唑(2002年0.9%至2009年2.3%,p<0.001)和泮托拉唑(2002年0.6%至2009年1.6%,p<0.001)的使用在研究期间显著增加。在使用PPI的患者访视中,62.9%的患者未记录胃肠道投诉、胃肠道诊断或其他使用PPI的指示原因。我们发现PPI的使用从2002年到2009年显著增加,其使用的记录适应症也是如此。2006年至2009年,新处方的PPI使用没有变化。需要更多的研究来确定PPI在美国门诊是否被过度使用。
Anecdotal reports and studies of select populations suggest that the use of proton pump inhibitors (PPIs) has increased since their introduction. We sought to determine recent trends in PPI use in the U.S. outpatient setting and characteristics of patients and physicians that may predict their use. We used data from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS) to estimate the prevalence of visits in which patients used PPIs from 2002 to 2009. We tested for associations between PPI use and patient, physician, and practice characteristics using data from 2009. We also estimated the prevalence of visits in which PPIs were used by patients without gastrointestinal complaints, diagnoses, or other indications for their use and tested for associations between patient and physician characteristics and PPI use in patients with no documented indication. PPIs were used in 4.0% of visits in 2002 and 9.2% in 2009 (p<0.001 for trend across years). The use of omeprazole (0.9% in 2002 to 3.9% in 2009, p<0.001), esomeprazole (0.9% in 2002 to 2.3% in 2009, p<0.001), and pantoprazole (0.6% in 2002 to 1.6% in 2009, p<0.001) increased significantly over the study period. Among visits by patients using PPIs, 62.9% documented no gastrointestinal complaints, gastrointestinal diagnoses, or other indicated reason for their use. We found that PPI use increased significantly from 2002 to 2009 as did documented indications for their use. Newly-prescribed PPI use did not change from 2006 to 2009. More research is needed to determine whether PPIs are overused in the U.S. outpatient setting.
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