High-intensity proton pump inhibitor (PPI) use is often recommended by physicians.
However, there is little proven benefit over standard proton pump inhibitor dosing in many clinical situations.
Dr Laura Targownik and colleauges from Canada calculated the prevalence and predictors of high-intensity proton pump inhibitor use.
The research team used a Canadian provincial administrative database to capture all proton pump inhibitor prescriptions between 1996 and 2004.
|Recent endoscopy was predictive of high-intensity PPI use|
|The American Journal of Gastroenterology|
The team defined high-intensity use as PPI use more than 2 times the standard PPI dose for greater than 45 of 90 days before the index date.
The researchers calculated the prevalence of high-intensity use at 4 index dates annually.
Stepwise logistic regression was performed to determine clinical and demographic factors associated with high-intensity proton pump inhibitor use.
The researchers found that the prevalence of high-intensity PPI use increased from 10% in 1997 to 14% in 2004.
Polypharmacy, concomitant use of antispasmodic/promotility agents, and recent endoscopy were most strongly predictive of high-intensity PPI use.
The team noted that severity of gastroesophageal reflux disease was relatively weakly predictive of high-intensity proton pump inhibitor use.
Dr Targownik's team concluded, "High-intensity proton pump inhibitor use is becoming more prevalent over time."
"Its use is strongly associated with factors suggestive of a high degree of comorbidity and treatment failure."
"Further research into factors that drive high-intensity proton pump inhibitor prescription and use are required."