PRESCRIBING OF ANTACIDS AND ULCER-HEALING DRUGS IN PRIMARY-CARE IN THE NORTH OF ENGLAND

Background: This study describes the pharmaco-epidemiology of ulcer-healing therapies in primary care in the north of England. Methods: Anonymous patient-specific prescribing data were extracted from computerized general practice records for 41 practices. Prescribing prevalences were determined according to patient age, gender and recorded prescription indication, for both antacids and H-2-receptor antagonists or omeprazole. Results: During the year of the study, antacids were prescribed for 3.9% of the study population, and H-2-receptor antagonists or omeprazole for 3.7%. Rates increased with age, peaking at 99 (antacids) and 87 (H-2-receptor antagonists) per 1000 population aged 65-84 years, Antacid prescribing rates for women were over twice those for men amongst those aged 15-34 years. For H-2-receptor antagonists, rates were higher in men than women, with the excess attributable to prescribing for ulcer indications, although at all ages prescribing for oesophagitis was more prevalent among women. Of the patients prescribed H-2-receptor antagonists or omeprazole, 45% (accounting for 51% of prescription items) had indications which included peptic ulcer or oesophagitis, 42% had gastritis or dyspepsia only (35% items), and in 13% no peptic indication was recorded. For each of antacids and H-2-receptor antagonists, the practices had similar prescribing profiles according to patient age and gender, but their absolute levels differed up to two-fold. Conclusions: Prescribing of antacids and ulcer-healing drugs varies systematically with patient age and gender. Consequently, evaluation of crude prescribing rates, without reference to patient demography, is unreliable as a guide to levels of usage. In general practice, H-2-receptor antagonists and omeprazole appear to be over-prescribed for minor indications.