Symptom control in primary care patients on long-term proton pump inhibitor (PPI) treatment is poorly understood.
Dr Raghunath and colleagues from the United Kingdom explored associations between symptom control and demographics, lifestyle, PPI use, diagnosis and Helicobacter pylori status.
The research team conducted a cross-sectional survey of 726 subjects using note reviews, questionnaires and carbon-13 urea breath testing.
Determinants of symptom control, including the Leeds Dyspepsia Questionnaire, Carlsson and Dent Reflux Questionnaire, and health-related quality-of-life measures were explored using stepwise linear regression.
|Severe dyspepsia symptoms occurred in 61% of subjects|
|Alimentary Pharmacology & Therapeutics|
Moderate or severe dyspepsia symptoms occurred in 61% of subjects, and reflux symptoms in 59%.
Age, gender, smoking and body mass index had little or no influence upon symptom control or PPI use.
Average symptom scores and PPI use were lower in patients with non-ulcer dyspepsia and gastro-protection than gastro-esophageal reflux disease (GERD) and uninvestigated dyspepsia.
H. pylori infection was associated with lower reflux symptom scores only in patients with GERD and uninvestigated dyspepsia.
EuroQoL (EQ)-5D was not able to discriminate between diagnostic groups, although the EQ-VAS performed well.
Dr Raghunath’s team concludes, “A majority of patients suffered ongoing moderate or severe symptoms.”
“GERD and uninvestigated dyspepsia were associated with poorer long-term symptom control.”
“H. pylori appeared to have a protective effect on reflux symptoms in these patients.”