Repeat prescribing of ulcer healing drugs in general practice - Prevalence and underlying diagnosis

Background: The long-term use of ulcer healing drugs in the management of dyspepsia is controversial, We have investigated repeat prescribing of these drugs in a general practice population. Aims: To identify the number of patients authorized to receive repeat prescriptions for ulcer healing drugs, and to review the investigation status and diagnosis in these patients. Subjects: A total of 15 495 patients registered with eight general practitioners in seven general practices in Dundee, UK. Methods: Case ascertainment by review of practice repeat prescribing registers. Data regarding investigation and diagnosis obtained by retrospective review of general practice case records. Results: Six hundred and seventy-nine (4.4% of the total population) were authorized to receive repeat prescriptions for ulcer healing drugs. Six hundred and fifty-one (4.2%) were authorized to receive repeat prescriptions for H-2-antagonists, Ranitidine was prescribed in 583 (86% of patients receiving ulcer healing drugs). Endoscopy had been performed in 426 (63%) and barium meal alone in 113 (17%); 140 (21%) had not been investigated, A diagnosis of peptic ulcer disease or oesophagitis was established in 382 (56%). However, 157 investigated patients (23% of all patients on ulcer healing drugs) did not have a peptic diagnosis. Conclusions: The prevalence of repeat prescribing of ulcer healing drugs in the general practice population studied was 4.4%, but 44% of these patients did not have a confirmed diagnosis of acid peptic disease.