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Patients continued PPI use despite testing negative for GERD
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More than 40% of patients remained on proton pump inhibitor therapy for GERD despite physiological evidence suggesting they did not have the condition in a recent study.
Researchers evaluated the charts of 90 patients who had tested negative for GERD through Bravo pH monitoring (n=66) or multichannel intraluminal impedance-pH (n=24) testing at Northwestern University in Chicago from January 2006 through January 2010. Participants also received a cross-sectional survey covering topics including symptom severity according to the GerdQ questionnaire, demographics, medication and health behaviors.
Proton pump inhibitor (PPI) use was reported by 38 participants (42.2%) despite results from pH studies indicating that they did not have GERD. The most commonly taken medications were esomeprazole (n=13) and omeprazole (n=11). Seventeen patients (18.9%) recalled being instructed to stop PPI treatment, while 15 (16.7%) had documented instructions to do so according to their charts.
Investigators found no significant differences in demographics or clinical characteristics according to PPI use, with the exception of alcohol use (62.9% of PPI patients compared with 90.0% not taking a PPI, P<.01). Patients taking PPIs were more likely to have a positive GerdQ score (55.6% vs. 21.1% of those not taking PPIs, P<.01), and also were more likely to experience troublesome daily symptoms (27.8% vs. 9.6% of those not taking PPIs, P=.04).
“Our findings suggest that a large proportion of patients with negative results from pH monitoring studies continue PPI therapy despite evidence contradicting the presence of GERD,” the researchers concluded. “Although this study was not designed to compare testing modalities, prospective studies are needed to determine how different testing modalities affect subsequent medication use, prescription patterns and patient outcomes.”
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