[Multicenter study of prescription-indication of antacids and antiulcer agents in primary care].

OBJECTIVES

To analyse the prevalence in primary care of use of drugs to treat acidity and ulcers, and to study how prescription of these medicines matches up with indication.

DESIGN

Crossover study of 1213 clinical histories selected according to simple random sampling.

SETTING

6 health centres in Navarra.

PATIENTS: 370 histories with a record of use of one of the drugs under study were chosen.

MEASUREMENTS AND MAIN

RESULTS

Between March and June 1997, third-year family and community medicine interns collected data based on a questionnaire designed by the Pharmaceutical Provision Service of the Navarra Health Service-Osasunbidea, where the information was subsequently processed. The prevalence of patients in treatment with the drugs being studied was 30.5%. On the use of these medicines as prophylactics (n = 206), 74.3% were indicated as gastro-protection by NSAIDs (n = 153). The risk factors recorded in these cases were described, by which at least 39.9% of the prescriptions were unjustified. In general the proton pump inhibitors were prescribed more by specialists (43.7% vs. 16.4%, p < 0.001), whereas primary care doctors used more drugs for acidity (40.8% vs 21.8%, p < 0.001) and zinc acexamate (7.7% vs. 0.7%, p = 0.002). The main differences between PC and specialists was seen in duodenal ulcer treatment and prevention with NSAIDs of gastropathy.

CONCLUSION

These results suggest it would be appropriate to establish mixed protocols (primary/specialist care) in order to tackle peptic ulcers better.