Overprescribing Hard to Change

Acid suppressing drugs like Aciphex, Nexium, Prevacid and Prilosec are incredibly popular, but are such proton pump inhibitors being overprescribed? Although such medications are important in treating severe reflux and conditions like Barrett’s esophagus, they are probably overkill for garden-variety heartburn. But experts are uncertain about how to reduce the overuse of these PPIs.
Scientists in the Netherlands tested a program directed at doctors. More than 100 groups of primary care physicians were randomized to get an intervention designed to reduce their prescribing of of PPIs or to continue with their usual practice. As the researchers point out, most patients could get good symptom control if they took these drugs intermittently, but instead the drugs are usually taken continuously.
The intervention didn’t work. There was no difference in PPI prescriptions between the two groups at the end of the study. The researchers suggest that future interventions might be more successful if they were aimed at patients as well as physicians.
[Archives of Internal Medicine, July 26, 2010]