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British Journal of General Practice
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Research Article

Long-term prescribing of proton pump inhibitors in general practice.

A P Hungin, G P Rubin and H O'Flanagan
British Journal of General Practice 1999; 49 (443): 451-453.
A P Hungin
Centre for Health Studies, University of Durham.
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G P Rubin
Centre for Health Studies, University of Durham.
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H O'Flanagan
Centre for Health Studies, University of Durham.
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Abstract

BACKGROUND: Proton pump inhibitors (PPIs) constitute the largest sector of the National Health Service (NHS) community drugs bill (238 m Pounds; 5.6%). Little is known of the long-term prescribing component of this. AIM: To study the extent, the reasons for, and the cost implications of the long-term prescription of PPIs in general practice. METHOD: Subjects on long-term therapy were identified by searches of computerized and paper records from three practices, comprising 21 GPs with 46,650 patients, representing a population cross section in north-east England. RESULTS: Two hundred and nine (0.45%) patients were on long-term PPIs (range between practices = 0.3% to 0.55%): 87% were on omeprazole, 13% lansoprazole; average age = 60 years (male = 56 years, female = 64 years; range = 14 to 91 years); male to female ratio = 47:53. The main indications were 'reflux' (39%), 'oesophagitis' (17%), non-specified 'dyspepsia' (24%), 'peptic ulcer' (8%). During the study year, 1952 prescriptions (28-day courses) were issued: a mean of nine per patient (range = 1 to 8). Sixteen per cent of patients requested fewer than six prescriptions, 27% requested between six and nine prescriptions, and only 21% requested sufficient prescriptions for the entire year. The average cost was 3707 Pounds per general practitioner per annum, or 320,000 Pounds for the district, representing 40% of the total PPI bill. CONCLUSION: Of the total population, 0.45% were prescribed long-term PPIs; most for symptom relief. The long-term component comprised 40% of all PPI costs estimated at 100 million Pounds per annum for the United Kingdom. Most patients took their treatment only intermittently. More research is needed into strategies for rationalization of long-term PPI therapy. For most patients, doctors can advise on-demand rather than regular once-daily therapy.

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British Journal of General Practice: 49 (443)
British Journal of General Practice
Vol. 49, Issue 443
June 1999
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Long-term prescribing of proton pump inhibitors in general practice.
A P Hungin, G P Rubin, H O'Flanagan
British Journal of General Practice 1999; 49 (443): 451-453.

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Long-term prescribing of proton pump inhibitors in general practice.
A P Hungin, G P Rubin, H O'Flanagan
British Journal of General Practice 1999; 49 (443): 451-453.
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Print ISSN: 0960-1643
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