Treatment patterns in paediatric patients with a new diagnosis of gastroesophageal reflux disease.

Objective: Few data exist on the treatment of gastroesophageal reflux disease (GERD) in paediatrics. The objective of this study was to examine treatment patterns of GERD in paediatrics in the primary care. Methods: Incident GERD cases among paediatric patientswere identified using The Health Improvement Network UK primary care database. We assessed prescription treatments in 30 days before and any time after the date of diagnosis. Initial treatment was defined asthat received in 30 days either side of diagnosis. Odds ratios and 95% confidence intervals of receiving the treatment were calculated by multiple logistic regressions. Results: The incident GERD cohort comprised 1700 paediatric patients aged 1–17 years. Antacids were initiallyprescribed in 49.2% of patients. Similar proportions of patients (23.3 and 22.9%) received histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs); 7.5% were prescribed prokinetics and 19.3% received no prescribed treatment. Overall, 24.7% of initial H2RA users switched to PPIs, and 9.8% of those using PPIs switched toH2RAs. The likelihood of the use of PPI increased with age and was lower in girls than in boys (odds ratio: 0.7; 95% confidence interval: 0.5–0.9). Conclusions: Antacids are the drugs most frequently prescribed by primary care physicians to paediatric patients with GERD, and approximately half receive an initial course of antisecretory treatment with H2RAs or PPIs. This study suggests that treatment patterns in paediatrics differ from those in adults