376 Persistent GERD Symptoms Despite PPI Treatment - Prevalence and Patient Characteristics: Results From a Cross-Sectional Patient Survey

Abstract

INTRODUCTION: GERD is a common disorder often treated with proton pump inhibitors (PPIs). However, many patients experience persistent GERD symptoms despite PPI treatment. The objective of this study was to estimate the prevalence of persistent GERD symptoms despite PPI treatment and to describe the characteristics of these patients in the US adult population. METHODS: The Acumen Health Research Institute survey is a cross-sectional health survey of US adults in which a subgroup of participants self-identified as having GERD (GERD patients). Participants aged ≥ 18 years were recruited in 2018 using sampling framework that ensured a composition representative of the US population. Patients were asked about their GERD history, treatments, and symptoms using the GERD Symptom Assessment Scale. Health-related quality of life (HRQoL) was assessed using the Veterans RAND 12-item (VR-12) physical component summary (PCS), mental component summary (MCS), and health utility (VR-6D). Work productivity and sleep disturbance due to GERD were also assessed. Persistent GERD was defined a priori as the presence of bothersome symptoms on at least 2 days in the preceding week despite taking PPIs for at least 25 days per month. Effectiveness of PPI treatment was rated as “a little” or “a lot.” GERD patients with and without persistent GERD symptoms were compared using descriptive statistics. RESULTS: Of 12,348 survey respondents, 1566 (12.7%) self-identified as GERD patients; 855 (54.6%) reported taking PPIs. Of those, 301 (35.2%) met the definition for persistent GERD. Patients with persistent GERD had decreased HRQoL (36.2 vs. 40.5 PCS, 41.6 vs. 45.7 MCS, and 0.60 vs. 0.66 VR-6D) and greater impairment in work productivity (3.2 vs. 2.1 work hours/week missed due to health) than those without. GERD patients with persistent GERD were more likely to take antacids (50.2%) and H2-receptor antagonists (17.9%) in addition to their PPI than those without (30.9% and 13.4%, respectively). GERD patients with persistent symptoms had more difficulty with sleep than those without. In the preceding week, 38.2% and 14.4%, respectively, reported difficulty falling asleep because of GERD symptoms on > 2 nights, and 29.3% and 10.6%, respectively, woke because of GERD symptoms on > 2 nights. CONCLUSION: Among GERD patients taking PPIs, more than one-third had persistent symptoms. Patients with persistent GERD symptoms had decreased HRQoL, greater impairment of work productivity, and greater sleep disturbance than those without.