Prescription problems for vets on reflux drug

February 20, 2013

U.S. veterans diagnosed with gastroesophageal reflux disease (GERD) are frequently prescribed doses of proton pump inhibitors (PPIs), such as omeprazole (commonly known by brand names such as Prilosec), that are much higher than recommended —- and they are kept on the drug far too long, according to a new Northwestern Medicine® study.

PPIs are among the most widely used drugs in the nation, resulting in more than $11 billion in annual direct in the U.S. PPI overuse has been documented in previous studies, but this is the first study to examine initial prescriptions given to veterans with a new GERD diagnosis.

"We should always have a reevaluation after an initial prescription and ask, 'Does this patient need to be on this medication?'" said Andrew Gawron, M.D., first author of the study and a fellow in the division of gastroenterology and the Center for Healthcare Studies at Northwestern University Feinberg School of Medicine. " are provided ubiquitously in medicine, and although they provide relief for many , optimal prescribing is important to avoid prolonged, unnecessary use and cost."

Sherri LaVela, research assistant professor at Feinberg's Center for Healthcare Studies and a research health scientist at the Edward Hines, Jr. VA Hospital in Hines, IL, is Gawron's mentor and the senior author of the study, which was published Feb. 16 in the .

The researchers evaluated more than 1,600 Veterans at the Hines VA from 2003 to 2009. Here are the major findings, which highlight the potential problems:

  • The majority of patients received more than a three-month initial supply of medication.
  • Almost 25 percent of patients were given high total daily dose prescriptions.
  • Very few patients who started on high dose therapy had reductions in dosing more than two years after their initial prescription.
It is recommended that PPIs be prescribed at the lowest effective dose for four to eight weeks to treat GERD. If symptoms persist after eight weeks, efforts should be made to evaluate other potential causes of symptoms and alternative approaches to therapy. This approach is a top priority in the "Choosing Wisely" campaign initiated last year by the American Board of Internal Medicine and the American Gastroenterology Association.

"It seems that once these veterans are prescribed a PPI, they are rarely taken off of it," Gawron said. "Two years after their initial prescription, most are still on the drug."

This study highlights the importance of ensuring appropriate use of PPIs in all patients after they are initially prescribed, Gawron said.

Explore further: Aspirin, acid blocker a-day keeps GI bleeding

Related Stories

Aspirin, acid blocker a-day keeps GI bleeding

August 11, 2008

For patients with clogged heart arteries who take long-term, low-dose aspirin to prevent a cardiac event, adding a stomach acid-blocking drug to their daily routine has been shown to reduce their risk for upper gastrointestinal ...

Heartburn controlled with step down to once daily therapy

February 27, 2012

(HealthDay) -- The majority of gastroesophageal reflux disease (GERD) patients who take twice-daily proton pump inhibitor (PPI) therapy, are able to successfully step down to management of heartburn with a daily dose of dexlansoprazole ...

Many patients keep using PPIs after negative GERD test

June 5, 2012

(HealthDay) -- Nearly half of patients continue to use proton pump inhibitors (PPIs) even after pH studies confirm that they do not have gastroesophageal reflux disease (GERD), and most do not recall being instructed to stop ...

Recommended for you

In sub-Saharan Africa, cancer can be an infectious disease

August 26, 2016

In 1963, Irish surgeon Denis Parson Burkitt airmailed samples of an unusual jaw tumor found in Ugandan children to his colleague, Anthony Epstein, at Middlesex Hospital in London. Epstein, an expert in chicken viruses and ...

Zika virus may persist in the vagina days after infection

August 25, 2016

The Zika virus reproduces in the vaginal tissue of pregnant mice several days after infection, according to a study by Yale researchers. From the genitals, the virus spreads and infects the fetal brain, impairing fetal development. ...

Team discovers how Zika virus causes fetal brain damage

August 24, 2016

Infection by the Zika virus diverts a key protein necessary for neural cell division in the developing human fetus, thereby causing the birth defect microcephaly, a team of Yale scientists reported Aug. 24 in the journal ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.