Prescribing trends of proton pump inhibitors and histamine blockers among children in the United Kingdom (1998-2019): A population-based assessment

Pharmacoepidemiol Drug Saf. 2024 Feb;33(2):e5752. doi: 10.1002/pds.5752.

Abstract

Purpose: To describe the prescribing trends of proton pump inhibitors (PPIs) and H2 receptor antagonists (H2 RAs) among children with gastroesophageal reflux in the United Kingdom between 1998 and 2019.

Methods: We conducted a population-based retrospective cohort study using data from the Clinical Practice Research Datalink that included all children aged ≤18 years with a first ever diagnosis of gastroesophageal reflux between 1998 and 2019. Using negative binomial regression, we estimated crude and adjusted annual prescription rates per 1000 person-years and corresponding 95% confidence intervals (CIs) for PPIs and H2 RAs. We also assessed rate ratios of PPIs and H2 RAs prescription rates to examine changes in prescribing over time.

Results: Our cohort included 177 477 children with a first ever diagnosis of gastroesophageal reflux during the study period. The median age was 13 years (IQR: 1, 17) among children prescribed PPIs and 0.2 years (IQR: 0.1, 0.6) among those prescribed H2 RAs. The total prescription rate of all GERD drugs was 1468 prescriptions per 1000 person-years (PYs) (95% CI 1463-1472). Overall, PPIs had a higher prescription rate (815 per 1000 PYs, 95% CI 812-818) than H2 RAs (653 per 1000 PYs 95% CI 650-655). Sex- and age-adjusted rate ratios of 2019 versus 1998 demonstrated a 10% increase and a 76% decrease in the prescription rates of PPIs and H2 RAs, respectively.

Conclusions: Prescription rates for PPIs increased, especially during the first half of the study period, while prescription rates for H2 RA decreased over time.

Keywords: children; cohort; prescriptions proton pump inhibitors; reflux.

MeSH terms

  • Adolescent
  • Child
  • Gastroesophageal Reflux* / drug therapy
  • Gastroesophageal Reflux* / epidemiology
  • Histamine
  • Histamine H2 Antagonists / therapeutic use
  • Humans
  • Proton Pump Inhibitors* / therapeutic use
  • Retrospective Studies
  • United Kingdom / epidemiology

Substances

  • Proton Pump Inhibitors
  • Histamine
  • Histamine H2 Antagonists