Determinants of Gastroesophageal Reflux Disease (GERD) severity and Utilization of Proton Pump Inhibitors among GERD Patients: A Cross-Sectional Study

Background: Proton Pump Inhibitors (PPIs) are the first line agents in the treatment of gastro-esophageal reflux disease (GERD). The efficiency and safety profile of PPIs have driven to its over-utilization and the protracted recipients are targets to its long-term adverse such as chronic kidney disease (CKD), Clostridium difficile infection (CDI) and community-acquired pneumonia (CAP) etc. Therefore, the study was intended to explore the PPI utilization patterns in GERD patients in an Indian tertiary-care hospital.

Materials and Methods: A cross-sectional study was carried out at the Department of Gastroenterology, in a private tertiary care hospital, Bangalore, for a period of six months. The objective of the study was to identify the risk factors of GERD and prescribing trends of proton pump inhibitors in GERD patients.

Results: Among the 139 patients diagnosed with GERD, 66% were males. GERD was found to be more prevalent in the age group of 25-44 years. The GERD patients reported a relationship between the severity of disease and the following risk factors, namely, Smoking, OR: 0.446, alcoholism, OR: 1.26, BMI>24.9,OR:1.13 and mixed diet, OR:0.486. Rabeprazole (36.4%) was the commonly prescribed PPI. PPI combination therapy was prescribed in 56.11% of patients, followed by single therapy in 39.5% patients.

Conclusion: Creating awareness among the clinicians and patients on appropriate use of PPIs can reduce the additional economic burden and improve the health-related quality of life. Focusing on risk factors to identify preventive measures will help in decreasing the incident rate of GERD.