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Use of acid‐suppressive therapy before anti‐reflux surgery in 2922 patients: a nationwide register‐based study in Denmark
Author(s) -
Lødrup A.,
Pottegård A.,
Hallas J.,
Bytzer P.
Publication year - 2015
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13230
Subject(s) - medicine , reflux , medical prescription , dosing , danish , proton pump inhibitor , disease , population , pharmacotherapy , surgery , pharmacology , linguistics , philosophy , environmental health
Summary Background Guidelines recommend that patients with gastro‐oesophageal reflux disease are adequately treated with acid‐suppressive therapy before undergoing anti‐reflux surgery. Little is known of the use of acid‐suppressive drugs before anti‐reflux surgery. Aim To determine the use of proton pump inhibitors and H 2 ‐receptor antagonists in the year before anti‐reflux surgery . Methods A nationwide retrospective study of all patients aged ≥18 undergoing first‐time anti‐reflux surgery in Denmark during 2000–2012 using data from three different sources: the Danish National Register of Patients, the Danish National Prescription Register, and the Danish Person Register. Results The study population thus included 2922 patients (median age: 48 years, 55.7% male). The annual proportion of patients redeeming ≥180 DDD of acid‐suppressive therapy increased from 17.0% 5 years before anti‐reflux surgery to 64.9% 1 year before. The probability for inadequate dosing 1 year before surgery (<180 DDD ) was significantly increased for younger patients, patients operated in the period 2000–2003, patients who had not undergone pre‐surgical manometry, pH ‐ or impedance monitoring, and patients who had not redeemed prescriptions on NSAID or anti‐platelet drugs. Conclusion Compliance with medical therapy should be evaluated thoroughly before planning anti‐reflux surgery, as a high proportion of patients receive inadequate dosing of acid‐suppressive therapy prior to the operation.