Capsule Commentary on Gawron et al., Proton Pump Inhibitor Prescriptions and Subsequent Use in US Veterans Diagnosed with Gastroesophageal Reflux Disease

Excerpt

In this single-center study conducted at the Hines, IL, VA Hospital, Gawron et al.1 examined characteristics of initial and subsequent proton-pump inhibitor (PPI) prescribing in veterans within 30 days of an ICD-9 code for gastroesophageal reflux disease in the outpatient setting. They found that of these initial PPI prescriptions, 23.3 % were high dose, and the majority were for 90 days or more. Only 11.9 % of patients receiving an initial high-dose prescription and 3.3 % of patients overall had evidence of step-down therapy. Additionally, 83.8 % of patients received at least one refill, with a high medication possession ratio over 2 years. Taken together, these data suggest that few patients are receiving or successfully completing a trial of step-down or discontinuation of therapy. …