Pharmaceutical Research

, Volume 18, Issue 9, pp 1367–1372 | Cite as

Assessing NSAID Prescription Use as a Predisposing Factor for Gastroesophageal Reflux Disease in a Medicaid Population

  • Jeffrey Kotzan
  • William Wade
  • Hsin Hui Yu
Article

Abstract

Purpose. The purpose of the study was to determine the incidence of GERD associated with prescription NSAID consumption.

Methods. All Georgia Medicaid patients > 25 years of age and continuously eligible for 1996, 1997, and 1998 were included in the study. Patients were excluded if they received a GERD diagnoses during 1996 and 1997. Patients were observed in 1998 and classified into GERD and control cohorts. Comorbidities, demographics, and NSAID prescription consumption were retained and modeled with logistic regression.

Results. The absolute risk of developing GERD without previous NSAID consumption was 0.38. The absolute risk of developing GERD for those patients who consumed one or more NSAID prescriptions during 1996 and 1997 was 0.80. Thus, the relative risk of GERD for NSAID patients was 2.11. GERD was significantly associated with one or more NSAID prescriptions (OR = 1.82), age (OR = 1.05 for 5 year range), gender (OR = 1.31 for females), asthma (OR = 3.24), obesity (OR = 2.77), hiatal hernia (OR = 4.17), tobacco use (OR = 2.56), and alcohol (OR = 1.83). The initial NSAID prescription was responsible for the greatest marginal increase in GERD.

Conclusions. Our study suggests that NSAIDs are associated with GERD especially for females, alcohol and tobacco users, and patients with asthma, hiatal hernia, or obesity.

NSAIDs non-steroidal anti-inflammatory drugs Medicaid GERD gastroesophageal reflux disease 

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REFERENCES

  1. 1.
    A. G. Klauser, N. E. Schindlbeck, and S. A. Muller-Lissner. Lancet 335:205–208 (1990).Google Scholar
  2. 2.
    M. M. Goldenberg. P-and-T. 23:583–593 (1989).Google Scholar
  3. 3.
    O. T. Nebel, M. F. Fornes, and D. O. Castell. Am. J. Dig. Dis. 21:953–956 (1976).Google Scholar
  4. 4.
    P. J. Kahrilas. JAMA 276:983–988 (1996).Google Scholar
  5. 5.
    W. J. Blot, S. S. Devesa, R. W. Kneller, and J. F. Fraumeni. JAMA 265:1287–1289 (1991).Google Scholar
  6. 6.
    C. E. Pope. N. Engl. J. Med. 331:656–660 (1994).Google Scholar
  7. 7.
    G. R. Locke, N. J. Talley, S. L. Fett, A. R. Zinsmeister, and L. J. Melton. Am. J. Med. 106:642–649 (1999).Google Scholar
  8. 8.
    M. Wienbeck, J. Barnert. Scand. J. Gastroenterol. Suppl. 156:7–13 (1989).Google Scholar
  9. 9.
    M. Ruth, I. Mansson, and N. Sandberg. Scand. J. Gastroenterol. 26:73–81 (1991).Google Scholar
  10. 10.
    P. Ryan, D. J. Hetzel, D. J. Shearman, and A. J. McMichael. J. Gastroenterol. Hepatol. 10:306–312 (1995).Google Scholar
  11. 11.
    S. J. Spechler. Digestion 51:24–29 (1992).Google Scholar
  12. 12.
    G. Morgan. Med. Hypotheses 6:42–44 (1996).Google Scholar
  13. 13.
    J. Sarosiek and R. W. McCallum. Am. J. Gastroenterol. 90:847–849 (1995).Google Scholar
  14. 14.
    A. I. Lanas, J. M. Blas, J. Ortego, J. Soria, and R. Sainz. Dig. Dis. Sci. 42:1003–1012 (1997).Google Scholar
  15. 15.
    J. C. Mason. Eur. J. Gastroenterol. Hepatol. 11:369–373 (1999).Google Scholar
  16. 16.
    L. E. Mansfield. Postgrad. Med. 86:265–269 (1989).Google Scholar
  17. 17.
    S. M. Harding. J. Allergy Clin. Immunol. 104:251–259 (1999).Google Scholar
  18. 18.
    S. J. Sontag,; S. O'Connell, S. Khandelwal, T. Miller, B. Nemchausky, T. G. Schnell, and R. Serlovsky. Gastroenterology 99:613–620 (1990).Google Scholar
  19. 19.
    L. E. Mansfield and M. R. Stein. Ann. Allergy 41:224–226 (1978).Google Scholar
  20. 20.
    L. I. Kitchin and D. O. Castell. Arch. Intern. Med. 151:448–454 (1991).Google Scholar
  21. 21.
    M. Fein, M. P.Ritter, T. R. DeMeester, S. Oberg, J. H. Peters, J. A. Hagen, and C. G. Bremner. J. Gastrointest. Surg. 3:405–410 (1999).Google Scholar
  22. 22.
    C. Aalykke and T. Havelund. Ugeskr. Laeger 156:5105–5109 (1994).Google Scholar
  23. 23.
    M. B. Fennerty, D. Castell, A. M. Fendrick, M. Halpern, D. Johnson, P. J. Kahrilas, D. Leiberman, J. E. Richter, and R. E. Sampliner. Arch. Intern. Med. 156:477–484 (1996).Google Scholar
  24. 24.
    E. Dimenas. Scand. J. Gastroenterol. Suppl. 199:18–21 (1993).Google Scholar
  25. 25.
    T. L. Vaughan, D. C. Farrow, P. D. Hansten, W. H. Chow, M. D. Gammon, H. A. Risch, J. L. Stanford, J. B. Schoenberg, S. T. Mayne, H. Rotterdam, R. Dubrow, H. Ahsan, A. B. West, W. J. Blot, W. J., and J. F. Fraumeni. Cancer Epidemiol. Biomarkers Prev. 7:749–756 (1998).Google Scholar
  26. 26.
    J. Lagergren, R. Bergstrom, A. Lindgren, and O. Nyren. N. Engl. J. Med. 340:825–831 (1999).Google Scholar
  27. 27.
    L. I. Andersen and G. Jensen. J. Intern. Med. 230:5–10 (1991).Google Scholar
  28. 28.
    T. Schnell, S. J. Sontag, and T. Miller. Gastroenterology 100:A18 (1991).Google Scholar
  29. 29.
    N. S. Mann, M. F. Tsai, and P. K. Nair. Am. J. Gastroenterol. 84:1494–1496 (1989).Google Scholar
  30. 30.
    A. Sonnenberg, B. T. Massey, and S. Jacobsen. Dig. Dis. Sci. 39:183–188 (1994).Google Scholar
  31. 31.
    H. B. El Serag and A. Sonnenberg. Gut 41:594–599 (1997).Google Scholar
  32. 32.
    A. Sonnenberg, U. Steinkamp, A. Weise, W. Berges, M. Wienbeck, H. G. Rohner, and P. Peter. Gastroenterology 83:889–895 (1982).Google Scholar
  33. 33.
    L. M, Brown, C. A. Swanson, G. Gridley, G. M. Swanson, J. B. Schoenberg, R. S. Greenberg, D. T. Silverman, L. M. Pottern, R. B. Hayes, and A. G. Schwartz. J. Natl. Cancer Inst. 87:104–109 (1995).Google Scholar
  34. 34.
    D. Choy and R. Leung. Respirology 2:163–168 (1997).Google Scholar
  35. 35.
    J. Goldman and J. R. Bennett. Lancet 2:493–495 (1988).Google Scholar
  36. 36.
    R. S. Irwin, F. J. Curley, and C. L. French. Chest 103:1662–1669 (1993).Google Scholar
  37. 37.
    W. J. Hogan, D. A. Viegas, and D. H. Winship. J. Appl. Physiol. 32:755–760 (1972).Google Scholar
  38. 38.
    G. W. Dennish and D. O. Castell. N. Engl. J. Med. 284:1136–1137 (1971).Google Scholar
  39. 39.
    J. A. Kotzan, B. C. Martin, and W. E. Wade. Pharmacotherapy 19:363–369 (1999).Google Scholar
  40. 40.
    J. L. Goldstein, F.E Silverstein, N. M Agrawal, R. C. Hubbard, J. Kaiser, C. J Maurath, K. M. Verburg, and G. S. Geis. Am. J. Gastroenterol. 95:1681–1690 (2000).Google Scholar
  41. 41.
    W. G. Bensen, S. Z. Zhao, T. A. Burke, R. A. Zabinski, R. W Makuch, C. J. Maurath, N. M. Agrawal, and G. S. Geis. J. Rheumatol. 27:1876–1883 (2000).Google Scholar
  42. 42.
    D. J. Watson, S. E. Harper, P. L. Zhao, H. Quan, J. A. Bolognese, and T. J. Simon. Arch. Intern. Med. 160:2998–3003 (2000).Google Scholar

Copyright information

© Plenum Publishing Corporation 2001

Authors and Affiliations

  • Jeffrey Kotzan
    • 1
  • William Wade
    • 1
  • Hsin Hui Yu
    • 1
  1. 1.College of PharmacyUniversity of GeorgiaAthens

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