Trends in prescribing proton pump inhibitors in the Netherlands between 2001 and 2015

Background There is increasing concern about the widespread use of proton pump inhibitors (PPIs). They are highly effective to treat upper gastrointestinal tract disorders and short term side effects are limited, but long term use may be associated with serious side-effects. The aim of our study was to investigate the prevalence, incidence and duration of use of proton pump inhibitors over time. Methods Retrospective data from IADB.nl, a Dutch database of filled prescriptions (59 public pharmacies, about 600,000 patients), were examined to identify all patients receiving a PPI between 2001 and 2015. We calculated the incidence and prevalence of PPI use and the duration of treatment. Data were stratified for age and gender. Results We identified 299,134 patients using PPIs during the study period. Most frequently prescribed PPIs in the Netherlands in 2015 were omeprazole (77%) followed by pantoprazole (14%).The prevalence of PPI use increased from 5.6% in 2001 to 15.0% in 2015. The incidence more than doubled from 2.2% in 2001 to 5.2% in 2011. Between 2012 and 2015, the incidence remained relatively stable around 4.5%. Both incidence and prevalence of PPI use was higher among female patients and showed age dependency. The median duration of PPI use during the study period was 1 month. Out of all patients, 15% used PPIs for at least 12 months. In the group of older patients (>60 years) more than 50% used PPIs for more than 12 months . Conclusion The use of PPIs increased largely over the last 15 years, especially among older patients. Most of these vulnerable patients use PPIs for more than one year increasing the risk for serious side effects. The decrease in new users of PPIs may be due to PPIs no longer being reimbursed for short time use since 2012