OBJECTIVES: To analyse the prevalence in primary care of use of drugs to treat acidity and ulcers, and to study how prescription of these medicines matches up with indication. DESIGN: Crossover study of 1213 clinical histories selected according to simple random sampling. SETTING: 6 health centres in Navarra. PATIENTS: 370 histories with a record of use of one of the drugs under study were chosen. MEASUREMENTS AND MAIN RESULTS: Between March and June 1997, third-year family and community medicine interns collected data based on a questionnaire designed by the Pharmaceutical Provision Service of the Navarra Health Service-Osasunbidea, where the information was subsequently processed. The prevalence of patients in treatment with the drugs being studied was 30.5%. On the use of these medicines as prophylactics (n = 206), 74.3% were indicated as gastro-protection by NSAIDs (n = 153). The risk factors recorded in these cases were described, by which at least 39.9% of the prescriptions were unjustified. In general the proton pump inhibitors were prescribed more by specialists (43.7% vs. 16.4%, p < 0.001), whereas primary care doctors used more drugs for acidity (40.8% vs 21.8%, p < 0.001) and zinc acexamate (7.7% vs. 0.7%, p = 0.002). The main differences between PC and specialists was seen in duodenal ulcer treatment and prevention with NSAIDs of gastropathy. CONCLUSION: These results suggest it would be appropriate to establish mixed protocols (primary/specialist care) in order to tackle peptic ulcers better.
OBJECTIVES: To analyse the prevalence in primary care of use of drugs to treat acidity and ulcers, and to study how prescription of these medicines matches up with indication. DESIGN: Crossover study of 1213 clinical histories selected according to simple random sampling. SETTING: 6 health centres in Navarra. PATIENTS: 370 histories with a record of use of one of the drugs under study were chosen. MEASUREMENTS AND MAIN RESULTS: Between March and June 1997, third-year family and community medicine interns collected data based on a questionnaire designed by the Pharmaceutical Provision Service of the Navarra Health Service-Osasunbidea, where the information was subsequently processed. The prevalence of patients in treatment with the drugs being studied was 30.5%. On the use of these medicines as prophylactics (n = 206), 74.3% were indicated as gastro-protection by NSAIDs (n = 153). The risk factors recorded in these cases were described, by which at least 39.9% of the prescriptions were unjustified. In general the proton pump inhibitors were prescribed more by specialists (43.7% vs. 16.4%, p < 0.001), whereas primary care doctors used more drugs for acidity (40.8% vs 21.8%, p < 0.001) and zinc acexamate (7.7% vs. 0.7%, p = 0.002). The main differences between PC and specialists was seen in duodenal ulcer treatment and prevention with NSAIDs of gastropathy. CONCLUSION: These results suggest it would be appropriate to establish mixed protocols (primary/specialist care) in order to tackle peptic ulcers better.
Authors: Alfonso Carvajal; Luis H Martín Arias; Eva Vega; José Antonio García Sánchez; Igor Martín Rodríguez; Pilar García Ortega; Javier García del Pozo Journal: Eur J Clin Pharmacol Date: 2004-06-23 Impact factor: 2.953