Steigende Verordnungszahlen von Protonenpumpenhemmern im ambulant-ärztlichen Bereich über die Jahre 2005 − 2013

Zusammenfassung

Hintergrund: In vielen Ländern finden sich über die letzten Jahre erhebliche Verordnungsanstiege von Protonenpumpenhemmern (PPIs) und eine zunehmende Überversorgung mit diesen Mitteln wird kritisiert. Ziel dieser Studie ist es, die Versorgung mit PPIs in Deutschland nach Alter und Geschlecht sowie mögliche regionale und facharztspezifische Unterschiede zu untersuchen.

Methodik: Wir verwendeten Routinedaten der BARMER GEK aus den Jahren 2005 − 2013. Ausgewertet wurde die Verordnungsprävalenz, also der Anteil Personen, die mind. einmal im entsprechenden Jahr PPIs erhielten. Für 2013 wurden zusätzlich die verschreibenden Facharztgruppen sowie regionale Unterschiede untersucht.

Ergebnisse: Insgesamt stieg die Verordnungsprävalenz zwischen 2005 und 2013 nahezu linear von 8,2 % auf 16,2 % an (+ 97 %). Frauen wiesen stets höhere Werte auf als Männer. Eine Zunahme findet sich auch mit steigendem Alter (0 − 5 Jahre: 0,2 % bis 95 + Jahre: 39,5 % in 2013). Regionale Unterschiede sind vergleichsweise gering ausgeprägt (Interquartil-Range der Postleitregion: 15,0 − 17,0 %). Allgemeinmediziner, praktische Ärzte und hausärztliche Internisten verschreiben insgesamt 9 von 10 Packungen. Mit zunehmendem Alter steigt die Bedeutung dieser Facharztgruppe sogar noch weiter an (98,1 % bei 95 + Jahren).

Schlussfolgerung: Der Anteil Personen, die mind. einmal PPIs verordnet bekamen, hat sich über die letzten 9 Jahren verdoppelt. Das eigene Verschreibungsverhalten sollte v. a. bei Patienten mit Dauerverordnung regelmäßig kritisch hinterfragt werden.

Abstract

Background: In many countries, proton pump inhibitors (PPIs) are increasingly prescribed over recent years and there is evidence of overprescribing. The aim of this article was to analyse the utilization of PPIs in Germany with respect to age and sex and to study regional variations as well as differences regarding medical specialties.

Methods: We used claims data of the BARMER GEK for the years 2005 − 2013. Main outcome was the prescribing prevalence, e. g., the proportion of persons with at least one prescription of PPIs in the corresponding year. In addition, the prescribing medical specialties and regional differences were studied for the year 2013.

Results: Over the years 2005 to 2013, the prescribing prevalence increased linearly from 8.2 % to 16.2 % (+ 97 %). Females were more often affected than males. Prevalences were also increasing with age (0 − 5 years: 0.2 % to 95 + years: 39.5 % in 2013). Regional differences were comparatively low (interquartile range of the postal code regions: 15.0 − 17.0 %). General practitioners prescribed a large majority of PPIs (90.1 %) with even higher proportions in the older age (98.1 % in persons aged 95 + years).

Conclusions: The proportion of persons receiving PPIs has doubled over the past 9 years. Physicians should review their prescribing habits critically on a periodic basis.

Schlüsselwörter

Refluxösophagitis - gastrointestinale Blutung - Helicobacter pylori

Key words

reflux oesophagitis - gastrointestinal bleeding - Helicobacter pylori

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