Expert Opinion on the Prescription Practice of Proton Pump Inhibitors in Indian Settings for Managing Gastro-Esophageal Reflux Diseases

Background: Although proton pump inhibitors (PPIs) were widely prescribed, the perspectives of clinicians regarding PPIs in the management of gastro-esophageal reflux diseases (GERD) was lacking. So, this study intended to gather clinicians' opinion regarding the prescription practice of PPIs and other GERD-related experiences for managing gastroesophageal reflux disease in routine Indian settings.

Methods: This cross-sectional study gathered expert opinion of specialists using a 21-item, multiple-response questionnaire. The survey included questions pertaining to current prescription trends, clinical observations, and preferences related to the use of PPIs, and GERD-related experiences. Descriptive statistics were carried out for data analysis.

Results: The survey involved 205 clinicians, with the majority (49.76%) indicating the use of American College of Gastroenterology (ACG) guidelines for managing GERD in routine practice. Approximately 68% of the clinicians emphasized the symptoms of heartburn and/or regurgitation as the most important for diagnosing GERD. According to 53% of the clinicians, the most common symptom reported by GERD patients was heartburn. Proton pump inhibitors (PPIs) were favored by the majority of clinicians (87.32%) as the first-line treatment for GERD. Among PPIs, approximately 90% preferred pantoprazole due to its faster onset of action. Additionally, nearly 91% reported using domperidone as the preferred gastroprokinetic in combination with PPI therapy. About 57% of clinicians preferred pellets/capsules for PPI administration. Majority (85.37%) preferred pantoprazole as adjuvant therapy and most of them (98.54) reported no key side effects with PPI use.

Conclusion: The findings underscored the clinical utility of ACG guidelines for the effective management of GERD. PPIs were favored by the majority of clinicians as the first-line treatment for GERD, with pantoprazole emerging as the preferred choice due to its faster onset of action.