Peptic ulceration in general practice in England and Wales 1994-98: period prevalence and drug management

Background: Little is known about the burden of peptic ulcer in the community. Aims: To examine recent time trends in the period prevalence of peptic ulceration and its drug management, in England and Wales. Methods: For each year between 1994 and 1998, information on patients with a diagnosis of peptic ulceration was extracted from the General Practice Research Database. Results: The annual age-standardized period prevalence of peptic ulceration decreased from 3.3/1000 in 1994 to 1.5/1000 in 1998 for men, and from 1.8/1000 to 0.9/1000 for women. This decline was more evident among younger people, and among males registered with practices located in the most deprived electoral wards compared to those located in the least deprived. The proportion of patients receiving H-2 receptor antagonists declined from 68% in 1994 to 41% in 1998. In contrast, the proportion prescribed proton pump inhibitors rose from 46% to 66%. Conclusions: Over a 5-year period, the period prevalence of peptic ulceration has decreased markedly, especially among younger people and those from more deprived areas.