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Aliment Pharmacol Ther. 2009 Oct;30(7):725-32. doi: 10.1111/j.1365-2036.2009.04092.x. Epub 2009 Jul 8.

Clinical trial: long-term use of proton pump inhibitors in primary care patients - a cross sectional analysis of 901 patients.

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Department of Medical Gastroenterology, K√łge Hospital, Copenhagen University, Copenhagen, Denmark.



The use of proton pump inhibitors (PPIs) is extensive. While the incidence of new treatments remains stable, the prevalence of long-term treatment is rising. Studies have shown that up to 70% of patients on chronic acid suppression lack a verified indication for treatment.


To investigate primary care patient characteristics associated with long-term use of PPIs.


A cross-sectional analysis of 42,634 patients registered with 22 general practitioners was performed. Patients with prescriptions of > or =120 tablets/year were defined as long-term users. A survey of a subgroup of patients without verified indication was performed.


In all, 901 (2.1%) patients were long-term treated. Verified indications for treatment were identified for 247/901 (27%). An upper GI endoscopy had been performed in 418 patients (46%). Of the 194/654 without verified indication who participated in the survey, 71% reported heartburn/acid regurgitation as the reason for therapy. On-demand therapy was reported by 43/194 (22%) and previous attempts to withdraw by 119/194 (61%).


The prevalence of PPI long-term treatment among primary care patients is 2.1%. The main reason for treatment is reflux symptoms or verified GERD. Rationalization of use of PPIs is possible as daily treatment without attempts to discontinue is frequently observed.

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