CLINICAL guidelines in the USA advise people with Barrett’s oesophagus to use proton pump inhibitors (PPI) daily to lower the chance of it developing into dysplasia or neoplasia. Previous research on PPI use in this group hasn’t looked closely at differences in how well people stick to the treatment. Also, factors affecting adherence haven’t been fully explained.
This study by Charles Gaber, Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois Chicago, USA, and colleagues, analysed data from the Merative MarketScan Commercial Claims and Encounters database to investigate how well people stick to prescribed PPIs. They looked at a group of individuals diagnosed with Barrett’s oesophagus from 2010–2019. Using group-based trajectory models to identify different patterns of adherence to PPIs over time.
They found 79,701 people newly diagnosed with Barrett’s oesophagus and identified five distinct patterns of adherence to prescribed PPIs. These groups were consistently high (accounting for 44% of the population), moderate decline (18%), slow decline (12%), rapid decline (10%), and decline-then-increase (16%). Those who were already taking PPIs before diagnosis were less likely to show a decline in adherence compared to those who started PPIs post-diagnosis. Factors associated with belonging to a group showing declining adherence included being female, having a history of anxiety or depression, and having one or more visits to the emergency department in the previous year.
Through an exploratory approach, the researchers identified differences in how well people stick to prescribed PPIs. They found that less than half of individuals belonged to the consistently high adherence group, indicating that many people with Barrett’s oesophagus might not be getting sufficient medication treatment.
Reference
Gaber CE et al. Adherence to prescription proton pump inhibitor therapy amongst individuals diagnosed with Barrett’s esophagus. Pharmacoepidemiol Drug Saf. 2024;33(2):e5760. Epub ahead of print].
