PDF(Pubmed)
Abstract：
The growing prevalence of gastroesophageal reflux disease (GERD) needs to be carefully managed to relieve the symptoms and prevent complications. Complications of GERD can include erosive esophagitis, Barrett\'s esophagus and gastrointestinal (GI) bleeding. Proton pump inhibitors (PPIs) are typically first-line treatment for GERD alongside lifestyle changes in view of their effectiveness and cost-effectiveness. However, there are concerns with adherence to dosing regimens and recommended lifestyle changes reducing their effectiveness. There are also concerns about potential complications from chronic high-dose PPIs. These include an increased risk of chronic kidney disease, cardiovascular events and infections. Recommendations to physicians include prescribing or dispensing the lowest dose of PPI for the shortest time, with ongoing patient monitoring. Activities among community pharmacists and others have resulted in increased dispensing of PPIs without a prescription, which can be a challenge. PPIs are among the most prescribed and dispensed medicines in view of their effectiveness in managing GERD. However, there are concerns with the doses prescribed and dispensed as well as adherence to lifestyle advice. These issues and challenges need to be addressed by health authorities to maximize the role and value of PPIs.
摘要：
胃食管反流病（GERD）的患病率越来越高，需要仔细管理以缓解症状并预防并发症。GERD的并发症可能包括糜烂性食管炎，巴雷特食管和胃肠道（GI）出血。质子泵抑制剂（PPI）通常是GERD的一线治疗方法，同时考虑到其有效性和成本效益，生活方式的改变。然而,人们担心坚持给药方案和推荐的生活方式改变会降低其有效性.人们还担心慢性高剂量PPI的潜在并发症。这些包括慢性肾病的风险增加，心血管事件和感染。对医生的建议包括在最短的时间内开处方或分配最低剂量的PPI，正在进行患者监测。社区药剂师和其他人之间的活动导致在没有处方的情况下增加了PPI的分配，这可能是一个挑战。鉴于PPI在管理GERD方面的有效性，PPI是处方和分配最多的药物之一。然而,人们对处方和分配的剂量以及对生活方式建议的依从性感到担忧。卫生当局需要解决这些问题和挑战，以最大限度地发挥PPI的作用和价值。
