Repeat prescribing of ulcer healing drugs in general practice--prevalence and underlying diagnosis.

Abstract

The long-term use of ulcer healing drugs in the management of dyspepsia is controversial. We have investigated repeat prescribing of these drugs in a general practice population. To identify the number of patients authorized to receive repeat prescriptions for ulcer healing drugs, and to review the investigation status and diagnosis in these patients. A total of 15,495 patients registered with eight general practitioners in seven general practices in Dundee, UK. Case ascertainment by review of practice repeat prescribing registers. Data regarding investigation and diagnosis obtained by retrospective review of general practice case records. Six hundred and seventy-nine (4.4% of the total population) were authorized to receive repeat prescriptions for ulcer healing drugs. Six hundred and fifty-one (4.2%) were authorized to receive repeat prescriptions for H2-antagonists. Ranitidine was prescribed in 583 (86% of patients receiving ulcer healing drugs). Endoscopy had been performed in 426 (63%) and barium meal alone in 113 (17%); 140 (21%) had not been investigated. A diagnosis of peptic ulcer disease or oesophagitis was established in 382 (56%). However, 157 investigated patients (23% of all patients on ulcer healing drugs) did not have a peptic diagnosis. The prevalence of repeat prescribing of ulcer healing drugs in the general practice population studied was 4.4%, but 44% of these patients did not have a confirmed diagnosis of acid peptic disease.