Pharmacological dependency in chronic treatment of gastroesophageal reflux disease: a randomized controlled clinical trial.
Digestion
; 81(1): 43-52, 2010.
Article
em En
| MEDLINE
| ID: mdl-20029208
ABSTRACT
BACKGROUND:
Despite evidence of the overuse of acid suppressive medication for gastroesophageal reflux disease (GERD), a transfer to noncontinuous therapy after long-term treatment proves difficult.AIM:
To quantify the effect of blinded dosage reduction after long-term therapy on symptom control and quality of life while assessing pharmacological and placebo needs.METHODS:
Primary care patients with a history of GERD and long-term treatment were randomized to daily placebo with pantoprazole rescue (n = 141) or daily pantoprazole with placebo rescue (n = 62) upon relief after 4 weeks pantoprazole 20 mg. The number of rescue tablets, symptom control and generic quality of life were analyzed.RESULTS:
Measured from the daily placebo arm, 19% of the patients terminated treatment, 33% managed with 2-6 tablets/week, 38% needed a daily dosage and 10% needed more than a daily dosage in the long run. At these final dosages, symptom control and quality of life were dosage-independent and, furthermore, equal to values of patients on fixed daily pantoprazole. A temporal decrease in well-being was seen in 24% of the patients.CONCLUSION:
A significant placebo response is apparent in long-term users of acid suppressive medication and pharmacological dependency is overestimated. Despite their history of long-term treatment, the majority of GERD patients can be switched from daily to on-demand treatment without impairing symptom control and quality of life.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Refluxo Gastroesofágico
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Transtornos Relacionados ao Uso de Substâncias
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2-Piridinilmetilsulfinilbenzimidazóis
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Inibidores da Bomba de Prótons
Tipo de estudo:
Clinical_trials
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Digestion
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Holanda