Risk factors and prescription patterns of gastroesophageal reflux disease: HEAL study in Pakistan

Objectives: To determine the frequency of the use of proton-pump inhibitor therapy in patients with typical symptoms of gastroesophageal reflux disease and evaluate its risk factors. Methods: The cross-sectional study was conducted between June 2010 and February 2011 across 10 cities of Pakistan. Adult patients giving a current history of typical gastroesophageal reflux disease symptoms were included. Information on patient demography, medical history, family history, prescription patterns, lifestyle factors and dietary habits were collected. SPSS 18 was used for statistical analysis and descriptive statistics were used for the analysis of categorical and continuous variables. Results: Of the 1010 patients enrolled, 954(94.45%) formed the study population. Of them, 520(54.5%) were men. The overall mean age was 41.9±12.5 years, and 439 (46%) had body mass index 25kg/m2. Further, 805 (84.4%) reported history of dyspepsia while 692(72.5%) had gastroesophageal reflux disease during the preceding year. Family history of acid peptic disease was reported by 231(24.2%) patients. Prior to consultation, 505(52.9%) patients were on proton-pump inhibitors. Following consultation, 923(96.8%) patients were prescribed proton-pump inhibitors, with omeprazole being the preferred choice in 577(60.5%). Associated risk factors included regular use of nonsteroidal anti-inflammatory drugs in 355(37.2%) and current smoking in 210(22.0%). Consuming spicy meals was reported by 666(70.0%). Conclusion: Nearly half the patients with typical gastroesophageal reflux disease symptoms were overweight, and a majority consumed spicy meals. Proton-pump inhibitors were widely prescribed, and omeprazole was the preferred choice of drug.