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Symptoms in patients on long‐term proton pump inhibitors: prevalence and predictors
Author(s) -
RAGHUNATH A. S.,
HUNGIN A. P. S.,
MASON J.,
JACKSON W.
Publication year - 2009
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/j.1365-2036.2008.03897.x
Subject(s) - medicine , gerd , reflux , proton pump inhibitor , gastroenterology , helicobacter pylori , gastro , quality of life (healthcare) , disease , body mass index , cross sectional study , pathology , nursing
Summary Background Symptom control in primary care patients on long‐term proton pump inhibitor (PPI) treatment is poorly understood. Aim To explore associations between symptom control and demographics, lifestyle, PPI use, diagnosis and Helicobacter pylori status. Methods A cross‐sectional survey ( n = 726) using note reviews, questionnaires and carbon‐13 urea breath testing. Determinants of symptom control [Leeds Dyspepsia Questionnaire (LDQ), Carlsson and Dent Reflux Questionnaire (CDRQ), health‐related quality‐of‐life measures (EuroQoL: EQ‐5D and EQ‐VAS)] were explored using stepwise linear regression. Results Moderate or severe dyspepsia symptoms occurred in 61% of subjects (LDQ) and reflux symptoms in 59% (CDRQ). Age, gender, smoking and body mass index had little or no influence upon symptom control or PPI use. Average symptom scores and PPI use were lower in patients with non‐ulcer dyspepsia and gastro‐protection than gastro‐oesophageal reflux disease (GERD) and uninvestigated dyspepsia. H. pylori infection was associated with lower reflux symptom scores only in patients with GERD and uninvestigated dyspepsia. EQ‐5D was not able to discriminate between diagnostic groups, although the EQ‐VAS performed well. Conclusions A majority of patients suffered ongoing moderate or severe symptoms. GERD and uninvestigated dyspepsia were associated with poorer long‐term symptom control; H. pylori appeared to have a protective effect on reflux symptoms in these patients.