Digestive Diseases and Sciences

, Volume 53, Issue 6, pp 1519–1526

Comparing Resource Utilization and Gastrointestinal Outcomes in Patients Treated with Either Standard-Dose or High-Dose Proton Pump Inhibitors: A Matched Cohort Study

Original Paper


The use of double-dose proton pump inhibitors (PPIs) for initial management of upper gastrointestinal (UGI) symptoms is common, though little evidence supports this practice. The aim of this study was to determine whether initial prescription of double-dose PPIs in outpatients with UGI complaints is superior to standard-dose PPIs prescription in reducing resource utilization. Patients in the Manitoba Health database prescribed double-dose PPIs were matched to individuals prescribed PPIs at standard doses. UGI-related inpatient and outpatient resource utilization and prescription drug usage were compared for both groups over the following year. Cases and controls had a similar duration of PPI use, and no difference in either UGI-related outpatient visits or UGI-related hospital admissions. Twelve-month UGI related costs were higher for double-dose PPI users. Initial therapy with double-dose PPIs does not reduce GI-related resource utilization. Prescription of double-dose PPIs as initial therapy for upper gastrointestinal symptoms should be discouraged.


Proton pump inhibitors Gastroesophageal reflux disease Pharmacoepidemiology Resource utilization 

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Laura E. Targownik
    • 1
    • 2
    • 3
  • Colleen Metge
    • 3
    • 4
    • 5
  • Stella Leung
    • 1
  1. 1.Section of Gastroenterology, Department of Internal MedicineUniversity of ManitobaWinnipegCanada
  2. 2.WinnipegCanada
  3. 3.Manitoba Centre for Health PolicyUniversity of ManitobaWinnipegCanada
  4. 4.Faculty of PharmacyUniversity of ManitobaWinnipegCanada
  5. 5.Department of Community Health Services, Faculty of MedicineUniversity of ManitobaWinnipegCanada

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