First-time endoscopy and use of antisecretory medication: a population-based cohort study.

OBJECTIVE

Endoscopy is the gold standard for diagnostic evaluation of upper gastrointestinal symptoms. The relation between endoscopy and use of antisecretory medication on a population level is unknown. The aim of this study was to describe development in the number of patients undergoing first-time endoscopies and their use of antisecretory medication.

MATERIAL AND

METHODS

Data on the use of endoscopies and antisecretory medication (H2 blockers and proton-pump inhibitors) were extracted from five population-based databases and included all citizens in Funen County (population 470,000) who had first-time endoscopies between 1993 and 2002.

RESULTS

A total of 27,829 first-time endoscopy patients were identified. In 2002 the number of first-time endoscopies was 5.6/1000 persons. The proportion that had redeemed prescription(s) on antisecretory medication the last year before endoscopy increased from 33% (1095/3286) in 1993 to 41% (1012/2445) in 2002 (p = 0.000). Following endoscopy, average use of antisecretory medication increased by 90 defined daily doses (DDD)/patient/year (95% CI 84-96) in patients with oesophagitis (N = 4850), by 59 DDD/patient/year (95% CI 54-64) in peptic ulcer patients (N = 4373) and by 18 DDD/patient/year (95% CI 16-20) in patients with normal endoscopies (N = 16,400).

CONCLUSIONS

An increasing proportion of patients are treated with antisecretory medication before endoscopy. Following endoscopy, use of antisecretory medication increases irrespective of the diagnostic findings.