Pharmacoepidemiology of peptic ulcer in Smolensk: 15 years later

Objective.

To study management of patients with peptic ulcer based on outpatient card data and to evaluate changes in methods for diagnosis of H. pylori and treatment prescriptions compared with 2004– 2005.

Materials and Methods.

A total of 100 outpatient cards of patients aged 18 years and older who came to outpatient clinic visit for peptic ulcer over the period of 2015–2018 were analyzed. The results of this study were compared with the data from the pharmacoepidemiological study «Ulcer», which was performed in 2004–2005 in Smolensk.

Results.

The primary diagnosis of H. pylori in patients with peptic ulcer has been carried out more often over the past 15 years (18% in 2015–2018 vs 4.5% in 2004–2005). Appropriate anti-H. pylori therapy was prescribed in 31% of patients compared to 11% of patients in 2004–2005 (p < 0.01). There were no cases of prescribing drugs with unproven clinical efficacy, such as vitamins, aloe, potato juice, methyluracil, riboxin, etc. In 2004–2005, these drugs were administered to 56.5% of patients. The proportion of proton pump inhibitors and bismuth preparations use increased from 49.2% to 91% and from 7% to 26%, respectively. The incidence of antacid use significantly decreased from 60% to 10%. The proportion of clarithromycin prescriptions increased from 7.7% to 44%, but that of metronidazole prescriptions decreased from 40.6% to 15%. Over the past 15 years, confirmation of H. pylori eradication was performed more often (11% in 2015–2018 vs 1% in 2004–2005).

Conclusions.

There was an improvement in quality of medical care for patients with peptic ulcer. However, a high frequency of non-compliance with the standards for the diagnosis of H. pylori and peptic ulcer therapy was noted, which warrants additional organizational and educational measures.