Treatment patterns and symptom control in patients with GERD: US community-based survey

ABSTRACT

Background: Proton pump inhibitors (PPIs) are the most commonly used pharmacological treatment for gastroesophageal reflux disease (GERD).

Objective: To examine the utilization patterns of PPIs and other GERD-related medications, satisfaction with PPI treatment and presence of GERD symptoms.

Patients and methods: GERD patients using prescription PPIs were identified from a mixed-model HMO health plan. Utilization patterns of PPIs and other GERD medications, satisfaction with PPI treatment and presence of GERD symptoms were assessed using questionnaires.

Results: Among the 617 patients who completed the survey, 71.0% used PPIs once a day (QD), 22.2% used twice a day (BID) and 6.8% more than twice a day or on an as-needed basis. Approximately 42.1% of all patients supplemented their prescription PPIs with other GERD medications, including over-the-counter medications and H₂-receptor antagonists. Over 85% of the patients still experienced GERD symptoms and 82.7% nighttime symptoms. Overall, 72.8% of all patients were satisfied or very satisfied with their PPI treatment.

Limitations: The study used self-reported data which may have been subject to recall bias. As the study was conducted in a specific region of the US, the results may have limited generalizability to other US regions or countries.

Conclusions: Patients on PPI treatment often experience GERD symptoms and supplement their prescription PPIs with other GERD medications. A substantial proportion of GERD patients receiving PPI treatment are on a BID regimen. Furthermore, more than a quarter of the patients are not completely satisfied with their PPI treatment.

Key words: :

• Gastroesophageal reflux disease
• Proton pump inhibitor
• Symptom control

Transparency

Declaration of funding

This study was funded by Takeda Pharmaceuticals North America Inc., Deerfield, IL, USA.

Declaration of financial/other relationships

W.D.C. has disclosed that he has served as a speaker, a consultant and an advisory board member for Axcan, AGI, Ironwood, Novartis, P&G, Prometheus, Santuarus, Salix, SmartPill, TAP and Takeda Pharmaceuticals North America, Inc. R.R.M. has disclosed that she is an employee of Takeda Pharmaceuticals North America, Inc. E.Q.W., N.B. and M.L. have disclosed that they are employees of Analysis Group and have received consulting fees from Takeda Pharmaceuticals North America, Inc. S.K. has disclosed that he was an employee of TAP Pharmaceutical Products Inc., Lake Forest, IL (now a part of Takeda) at the time of study conduct and analysis. L.C. and B.P. have disclosed that they were employees of Analysis Group at the time of study conduct and analysis.

All peer reviewers receive honoraria from CMRO for their review work. Reviewer 1 has disclosed that he/she is a stockholder in PharmIdeas Research and Consulting, a clinical research organization. The other peer reviewer has disclosed that he/she has no relevant financial relationships.

Acknowledgment

The authors have disclosed no assistance in preparing this manuscript.

Notes

* Other OTC GERD-related medications included Prilosec OTC, Tagamet HB, Zantac 75, Zantac 150, Zantac 150 EFFER, Axid AR, Pepcid AC, Pepcid Complete, Mylanta AR, Mylanta, Maalox, Pepto Bismol, Gaviscon, Rolaids, Tums, and other antacids as specified by patients in the survey. Other prescription GERD-related medications included Tagamet (cimetidine), Zantac (ranitidine), Axid (nizatidine), Pepcid (famotidine), and Carafate (sucralfate).