Primary Care Practitioners’ Views on the Use of Proton Pump Inhibitors Associated with Alginate-Antacids for Better Gastroesophageal Reflux Disease Symptom Control: Results of a National Survey in Spain
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Background: Gastroesophageal reflux disease (GERD)
is a prevalent disease in Western countries. Despite effective treatment
modalities, in some patients total symptom control is not achieved in
clinical practice. A cross-sectional study was designed to assess
primary care practitioners’ views on the effectiveness of proton pump
inhibitors (PPI) as monotherapy in the control of the most common
symptoms of GERD (heartburn and regurgitation), as well as to determine
the level of implementation of the “combined therapy” (PPI +
alginate-antacids). Methods: A questionnaire on different aspects of the
management of GERD was completed by 1491 primary care physicians. The
questionnaire was composed of 11 close-ended questions with one-choice
answer, with a total of 52 items, covering the main data from patients
presenting with GERD. Results: Treatment with PPI alone was mostly
considered insufficient for the control of GERD symptoms. The combined
treatment of PPI + alginate-antacids was used for 37% and 21% of
physicians for treating heart-burn and regurgitation, respectively. A
better control of symptoms, an increase in the onset of action and to
reduce nocturnal acid breakthrough were the most frequently argued
reasons for the use of PPI + alginate-antacids. A high percentage of
participants believed that treatment with PPI alone was insufficient for
the control of symptoms and 39.8% of physicians reported the
persistence of heartburn, 38.6% the persistence of regurgitation and
43.2% the persistence of epigastric discomfort in more than 25% of their
patients treated with PPI as monotherapy. The most common schedule for
the use of the antacid medication was on demand. Conclusions: Spanish
primary care physicians consider that a high proportion of GERD patients
continue to suffer from symptoms during PPI treatment alone. Ondemand
“combined therapy” (PPI + antacid) is considered an efficient option to
control reflux symptoms still troublesome in patients with PPI treatment
alone.
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Cite this paper
Argila, C. , Belinchón, M. and Martínez, A.
(2014) Primary Care Practitioners’ Views on the Use of Proton Pump
Inhibitors Associated with Alginate-Antacids for Better Gastroesophageal
Reflux Disease Symptom Control: Results of a National Survey in Spain. Open Journal of Gastroenterology, 4, 335-345. doi: 10.4236/ojgas.2014.410048.
[1] |
Boeckxstaens, G.E. (2009)
Emerging Drugs for Gastroesophageal Reflux Disease. Expert Opinion on
Emerging Drugs, 14, 481-491. http://dx.doi.org/10.1517/14728210903133807 |
[2] |
Dent, J., El-Serag, H.B.,
Wallander, M.A. and Johansson, S. (2005) Epidemiology of
Gastro-Oesophageal Reflux Disease: A Systematic Review. Gut, 54,
710-717. http://dx.doi.org/10.1136/gut.2004.051821 |
[3] |
El-Serag, H.B. (2007) Time
Trends of Gastroesophageal Reflux Disease: A Systematic Review. Clinical
Gastroenterology and Hepatology, 5, 17-26. http://dx.doi.org/10.1016/j.cgh.2006.09.016 |
[4] |
Peery, A.F., Dellon, E.S., Lund,
J., Crockett, S.D., McGowan, C.E., Bulsiewicz, W.J., Gangarosa, L.M.,
Thiny, M.T., Stizenberg, K., Morgan, D.R., Ringel, Y., Kim, H.P.,
Dacosta DiBonaventura, M., Carroll, C.F., Allen, J.K., Cook, S.F.,
Sandler, R.S., Kappelman, M.D. and Shaheen, N.J. (2012) Burden of
Gastrointestinal Disease in the United States: 2012 Update.
Gastroenterology, 143, 1179-1187. http://dx.doi.org/10.1053/j.gastro.2012.08.002 |
[5] |
Rosemurgy, A.S., Donn, N., Paul,
H., Luberice, K. and Ross, S.B. (2011) Gastroesophageal Reflux Disease.
Surgical Clinics of North America, 91, 1015-1029. http://dx.doi.org/10.1016/j.suc.2011.06.004 |
[6] | Lenglinger, J., Riegler, M., Cosentini, E., Asari, R., Mesteri, I., Wrba, F. and Schoppmann, S.F. (2012) Review on the Annual Cancer Risk of Barrett’s Esophagus in Persons with Symptoms of Gastroesophageal Reflux Disease. Anticancer Research, 32, 5465-5473. |
[7] |
Belhocine, K. and Galmiche, J.P.
(2009) Epidemiology of the Complications of Gastroesophageal Reflux
Disease. Digestive Diseases, 27, 7-13. http://dx.doi.org/10.1159/000210097 |
[8] |
Liker, H., Hungin, A.P. and
Wiklund, I. (2005) Management of Reflux Disease in Primary Care: The
Patient Perspective. Journal of the American Board of Family Practice,
18, 393-400. http://dx.doi.org/10.3122/jabfm.18.5.393 |
[9] |
Tack, J., Becher, A., Mulligan,
C. and Johnson, D.A. (2012) Systematic Review: The Burden of Disruptive
Gastro-Oesophageal Reflux Disease on Health-Related Quality of Life.
Alimentary Pharmacology & Therapeutics, 35, 1257-1266. http://dx.doi.org/10.1111/j.1365-2036.2012.05086.x |
[10] |
Kennedy, T. and Jones, R. (2000)
The Prevalence of Gastro-Oesophageal Reflux Symptoms in a UK Population
and the Consultation Behaviour of Patients with These Symptoms.
Alimentary Pharmacology & Therapeutics, 14, 1589-1594. http://dx.doi.org/10.1046/j.1365-2036.2000.00884.x |
[11] |
Bruley Des Varannes, S., Marek,
L., Humeau, B., Lecasble, M. and Colin, R. (2006) Gastroesophageal
Reflux Disease in Primary Care: Prevalence, Epidemiology and Quality of
Life of Patients. Gastroentérologie Clinique et Biologique, 30, 364-370.
http://dx.doi.org/10.1016/S0399-8320(06)73189-X |
[12] |
Hungin, A.P., Hill, C. and
Raghunath, A. (2009) Systematic Review: Frequency and Reasons for
Consultation for Gastro-Oesophageal Reflux Disease and Dyspepsia.
Alimentary Pharmacology & Therapeutics, 30, 331-342. http://dx.doi.org/10.1111/j.1365-2036.2009.04047.x |
[13] |
Castell, D.O., Murray, J.A.,
Tutuian, R., Orlando, R.C. and Arnold, R. (2004) Review Article: The
Pathophysiology of Gastro-Oesophageal Reflux Disease—Oesophageal
Manifestations. Alimentary Pharmacology & Therapeutics, 20, 14-25. http://dx.doi.org/10.1111/j.1365-2036.2004.02238.x |
[14] |
Fass, R., Shapiro, M., Dekel, R.
and Sewell, J. (2005) Systematic Review: Proton-Pump Inhibitor Failure
in Gastro-Oesophageal Reflux Disease—Where Next? Alimentary Pharmacology
& Therapeutics, 22, 79-94. http://dx.doi.org/10.1111/j.1365-2036.2005.02531.x |
[15] |
Dekel, R., Morse, C. and Fass,
R. (2004) The Role of Proton Pump Inhibitors in Gastro-Oesophageal
Reflux Disease. Drugs, 64, 277-295. http://dx.doi.org/10.2165/00003495-200464030-00004 |
[16] |
Miner Jr., P.B. (2006) Review
Article: Physiologic and Clinical Effects of Proton Pump Inhibitors on
Non-Acidic and Acidic Gastro-Oesophageal Reflux. Alimentary Pharmacology
& Therapeutics, 23, 25-32. http://dx.doi.org/10.1111/j.1365-2036.2006.02802.x |
[17] |
Sifrim, D. and Zerbib, F. (2012)
Diagnosis and Management of Patients with Reflux Symptoms Refractory to
Proton Pump Inhibitors. Gut, 61, 1340-1354. http://dx.doi.org/10.1136/gutjnl-2011-301897 |
[18] | Hrelja, N. and Zerem, E. (2011) Proton Pump Inhibitors in the Management of Gastroesophageal Reflux Disease. Medicinski Arhiv, 65, 52-55. |
[19] |
Frazzoni, M., Piccoli, M.,
Conigliaro, R., Manta, R., Frazzoni, L. and Melotti, G. (2013)
Refractory Gastroesophageal Reflux Disease as Diagnosed by Impedance-pH
Monitoring Can Be Cured by Laparoscopic Fundoplication. Surgical
Endoscopy, 27, 2940-2946. http://dx.doi.org/10.1007/s00464-013-2861-3 |
[20] |
Dean, B.B., Gano Jr., A.D.,
Knight, K., Ofman, J.J. and Fass, R. (2004) Effectiveness of Proton Pump
Inhibitors in Nonerosive Reflux Disease. Clinical Gastroenterology and
Hepatology, 2, 656-664. http://dx.doi.org/10.1016/S1542-3565(04)00288-5 |
[21] |
Tytgat, G.N., McColl, K., Tack,
J., Holtmann, G., Hunt, R.H., Malfertheiner, P., Hungin, A.P. and
Batchelor, H.K. (2008) New Algorithm for the Treatment of
Gastro-Oesophageal Reflux Disease. Alimentary Pharmacology &
Therapeutics, 27, 249-256. http://dx.doi.org/10.1111/j.1365-2036.2007.03565.x |
[22] | Dettmar, P.W., Hampson, F.C., Jain, A., Choubey, S., Little, S.L. and Baxter, T. (2006) Administration of Alginate Based Gastric Reflux Suppressant on the Bioavailability of Omeprazole. Indian Journal of Medical Research, 123, 517-524. |
[23] |
DeVault, K.R. and Castell, D.O.
(2005) Updated Guidelines for the Diagnosis and Treatment of
Gastroesophageal Reflux Disease. American Journal of Gastroenterology,
100, 190-200. http://dx.doi.org/10.1111/j.1572-0241.2005.41217.x |
[24] |
Dorval, E., Rey, J.F., Soufflet,
C., Halling, K. and Barthélemy, P. (2011) Perspectives on
Gastroesophageal Reflux Disease in Primary Care: The REFLEX Study of
Patient-Physician Agreement. BMC Gastroenterology, 11, 25. http://dx.doi.org/10.1186/1471-230X-11-25 |
[25] |
Ferrús, J.A., Zapardiel, J. and
Sobreviela, E., SYMPATHY I Study Group (2009) Management of
Gastroesophageal Reflux Disease in Primary Care Settings in Spain:
SYMPATHY I Study. European Journal of Gastroenterology & Hepatology,
21, 1269-1278. http://dx.doi.org/10.1097/MEG.0b013e32832a7d9b |
[26] |
Bell, N.J.V., Burget, D.,
Howden, C.W., Wilkinson, J. and Hunt, R.H. (1992) Appropriate Acid
Suppression for the Management of Gastro-Oesophageal Disease. Digestion,
51, 59-67. http://dx.doi.org/10.1159/000200917 |
[27] |
Manabe, N., Haruma, K., Ito, M.,
Takahashi, N., Takasugi, H., Wada, Y., Nakata, H., Katoh, T., Miyamoto,
M. and Tanaka, S. (2012) Efficacy of Adding Sodium Alginate to
Omeprazole in Patients with Nonerosive Reflux Disease: A Randomized
Clinical Trial. Diseases of the Esophagus, 25, 373-380. http://dx.doi.org/10.1111/j.1442-2050.2011.01276.x |
[28] |
Bell, N.J. and Hunt, R.H. (1992)
Role of Gastric Acid Suppression in the Treatment of Gastro-Oesophageal
Reflux Disease. Gut, 33, 118-124. http://dx.doi.org/10.1136/gut.33.1.118 |
[29] |
Chey, W.D., Nody, R.R. and Izat,
E. (2010) Patient and Physician Satisfaction with Proton Pump
Inhibitors (PPIs): Are There Opportunities for Improvement? Digestive
Diseases and Sciences, 55, 3415-3422. http://dx.doi.org/10.1007/s10620-010-1209-2 |
[30] | Van Zanten, S.J., Henderson, C. and Hughes, N. (2012) Patient Satisfaction with Medication for Gastroesophageal Reflux Disease: A Systematic Review. Canadian Journal of Gastroenterology, 26, 196-204. |
[31] |
Chey, W.D., Mody, R.R., Wu,
E.Q., Chen, L., Kothari, S., Persson, B., Beaulieu, N. and Lu, M. (2009)
Treatment Patterns and Symptom Control in Patients with GERD: US
Community-Based Survey. Current Medical Research and Opinion, 25,
1869-1878. http://dx.doi.org/10.1185/03007990903035745 |
[32] |
Kahrilas, P.J., McColl, K., Fox,
M., O’Rourke, L., Sifrim, D., Smout, A.J. and Boeckxstaens, G. (2013)
The Acid Pocket: A Target for Treatment in Reflux Disease? American
Journal of Gastroenterology, 108, 1058-1064. http://dx.doi.org/10.1038/ajg.2013.132 |
[33] |
Katz, P.O., Gerson, L.B. and
Vela, M.F. (2013) Guidelines for the Diagnosis and Management of
Gastroesophageal Reflux Disease. American Journal of Gastroenterology,
108, 308-328. http://dx.doi.org/10.1038/ajg.2012.444 |
[34] | Tran, T., Lowry, A.M. and El-Serag, H.B. (2007) Meta-Analysis: The Efficacy of Over-the-Counter Gastro-Oesophageal Reflux Disease Therapies. Alimentary Pharmacology & Therapeutics, 25, 143-153. |
[35] | Fennerty, M.B., Finke, K.B., Kushner, P.R., Peura, D.A., Record, L., Riley, L., Ruoff, G.E., Simonson, W. and Wright, W.L. (2009) Short- and Long-Term Management of Heartburn and Other Acid-Related Disorders: Development of an Algorithm for Primary Care Providers. Journal of Family Practice, 58, S1-S12. eww141027lx |
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