TY - JOUR

T1 - Use of acid-suppressive therapy before anti-reflux surgery in 2922 patients

T2 - a nationwide register-based study in Denmark

AU - Lødrup, A

AU - Pottegård, A

AU - Hallas, J

AU - Bytzer, P

N1 - © 2015 John Wiley & Sons Ltd.

PY - 2015/7

Y1 - 2015/7

N2 - BACKGROUND: Guidelines recommend that patients with gastro-oesophageal reflux disease are adequately treated with acid-suppressive therapy before undergoing anti-reflux surgery. Little is known of the use of acid-suppressive drugs before anti-reflux surgery.AIM: To determine the use of proton pump inhibitors and H2 -receptor antagonists in the year before anti-reflux surgery.METHODS: A nationwide retrospective study of all patients aged ≥18 undergoing first-time anti-reflux surgery in Denmark during 2000-2012 using data from three different sources: the Danish National Register of Patients, the Danish National Prescription Register, and the Danish Person Register.RESULTS: The study population thus included 2922 patients (median age: 48 years, 55.7% male). The annual proportion of patients redeeming ≥180 DDD of acid-suppressive therapy increased from 17.0% 5 years before anti-reflux surgery to 64.9% 1 year before. The probability for inadequate dosing 1 year before surgery (<180 DDD) was significantly increased for younger patients, patients operated in the period 2000-2003, patients who had not undergone pre-surgical manometry, pH- or impedance monitoring, and patients who had not redeemed prescriptions on NSAID or anti-platelet drugs.CONCLUSION: Compliance with medical therapy should be evaluated thoroughly before planning anti-reflux surgery, as a high proportion of patients receive inadequate dosing of acid-suppressive therapy prior to the operation.

AB - BACKGROUND: Guidelines recommend that patients with gastro-oesophageal reflux disease are adequately treated with acid-suppressive therapy before undergoing anti-reflux surgery. Little is known of the use of acid-suppressive drugs before anti-reflux surgery.AIM: To determine the use of proton pump inhibitors and H2 -receptor antagonists in the year before anti-reflux surgery.METHODS: A nationwide retrospective study of all patients aged ≥18 undergoing first-time anti-reflux surgery in Denmark during 2000-2012 using data from three different sources: the Danish National Register of Patients, the Danish National Prescription Register, and the Danish Person Register.RESULTS: The study population thus included 2922 patients (median age: 48 years, 55.7% male). The annual proportion of patients redeeming ≥180 DDD of acid-suppressive therapy increased from 17.0% 5 years before anti-reflux surgery to 64.9% 1 year before. The probability for inadequate dosing 1 year before surgery (<180 DDD) was significantly increased for younger patients, patients operated in the period 2000-2003, patients who had not undergone pre-surgical manometry, pH- or impedance monitoring, and patients who had not redeemed prescriptions on NSAID or anti-platelet drugs.CONCLUSION: Compliance with medical therapy should be evaluated thoroughly before planning anti-reflux surgery, as a high proportion of patients receive inadequate dosing of acid-suppressive therapy prior to the operation.

KW - Adult

KW - Denmark

KW - Electric Impedance

KW - Female

KW - Gastroesophageal Reflux

KW - Histamine H2 Antagonists

KW - Humans

KW - Male

KW - Middle Aged

KW - Proton Pump Inhibitors

KW - Retrospective Studies

U2 - 10.1111/apt.13230

DO - 10.1111/apt.13230

M3 - Journal article

C2 - 25939580

VL - 42

SP - 84

EP - 90

JO - Alimentary Pharmacology and Therapeutics, Supplement

JF - Alimentary Pharmacology and Therapeutics, Supplement

SN - 0953-0673

IS - 1

ER -