Use of antacids, alginates and proton pump inhibitors: a survey of the general Danish population using an internet panel

Abstract

Objective. Both over-the-counter medicine, such as antacids or alginates, and proton pump inhibitors (PPI) are used for treating acid-related disorders. We sought to describe what characterizes users of these different medicines, including long-term PPI users within the general population. Method. A cross-sectional survey was conducted in an internet panel representative of the Danish adult population in 2012. Data queried included antacid/alginate and PPI use, reason for therapy, co-medication, and presence of upper gastrointestinal symptoms. Long-term PPI use was defined as using PPI ≥1/3 of the last year (∼120 days). Risk of long-term PPI use was estimated by logistic regression. Results. A total of 18,223 people received the questionnaire, of which 52% (9390) responded. Antacid/alginate use was reported by 23%; 16% reported use of only antacid/alginate. PPI use was reported by 13.6%; 6.2% were defined as long-term PPI users. Antacid/alginate users were younger, used less co-medication, had most often started on therapy because of reflux symptoms, and had less often ongoing symptoms. Risk of long-term PPI use appeared to be increased in male gender, by renewing PPI prescription by phone/e-mail, using co-medication, and having started on PPI for several reasons. Combination of antacid/alginate and PPI was reported by approximately 50% of those on therapy with weekly or daily symptoms. Conclusion. 23% of Danish adults were using antacids or alginates and 14% were using PPI, of which one-half were on long-term therapy. Prescription renewal by phone or e-mail and use of other prescription medication were associated with long-term PPI use, indicating a behavioral pattern, in which unnecessary PPI therapy may be maintained.

Key Words::

• alginate
• antacid
• dyspepsia
• general population
• internet panel
• over-the-counter medicine
• proton pump inhibitor
• reflux

Acknowledgments

Anders Lødrup is guarantor of this article and takes responsibility for the integrity of the work as a whole. The following authors contributed to this work and article: Anders Lødrup (AL), Christina Reimer (CR) and Peter Bytzer (PB). AL, CR and PB planned and designed the study, analyzed the results, and wrote the article. The internet survey was carried out by a marketing research and consulting firm (MEGAFON). All authors have approved the final version of the article, including the authorship list.

Declaration of interest: Anders Lødrup has received research funding from Reckitt Benckiser Group. Peter Bytzer has served as an advisory board member for Astra Zeneca, Novartis Healthcare, and Reckitt Benckiser Group. This study was funded in part by Reckitt Benckiser, Denmark.