Proton pump inhibitors (PPIs) are the most potent drug treatment for gastro-esophageal reflux disease (GERD).
However, premeal dosing maximizes efficacy while sub-optimal dose timing may limit efficacy.
Dr Gunaratnam and colleagues determined the prevalence of sub-optimal PPI dosing in a community-based GERD population of 100 patients.
The investigative team questioned the patients about their proton pump inhibitor dosing habits and classified them as optimal or sub-optimal dosers.
Optimal dosers took proton pump inhibitors with or up to 60 minutes before meals.
|39% were dosing more than 60 minutes before meals|
|Alimentary Pharmacology & Therapeutics|
The investigators noted that sub-optimal dosers took proton pump inhibitors more than 60 minutes before meals, after meals, as needed, or at bedtime.
The investigative team found that 46% dosed optimally.
The team observed that 54 % dosed sub-optimally with 39% dosing more than 60 minutes before meals, 30% after meals, 28% at bedtime, and 4% as needed.
Only 6% of the subjects on once-daily proton pump inhibitor regimens dosed 15 to 30 minutes before a meal.
The team found that 33% of subjects taking proton pump inhibitors 2- to 3 times daily dosed in a manner that maximized acid suppression.
Dr Gunaratnam's team concludes, “In this study, 54% of patients dosed proton pump inhibitors sub-optimally, and only 12% dosed in a manner that maximized acid suppression.”
“As sub-optimal proton pump inhibitor dose timing can limit efficacy, patients with refractory symptoms should be asked about dose timing to avoid inappropriate and costly dose escalations.”