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Treatment Satisfaction with Medications for Gastroesophageal Reflux Disease:
Results from a Large Disease Registry

Murtuza Bharmal, PhD1; Elisa Cascade, MBA2; Michelle Thiny, MD, MPH3
1Quintiles, Inc., Rockville, MD, USA; 2iGuard Inc., Princeton, NJ, USA; 3Quintiles Inc., Morrisville, NC, USA
Figure 1. Least Square Means by PPI Medications
 Gastrointestinal Reflux Disease (GERD), a condition in which the contents of the stomach reflux backwards into the esophagus, has been associated with a huge economic burden in western countries and significantly decreased quality of life.1 Esomeprazole
 The most widely used treatment options for GERD include proton-pump inhibitors (PPIs) and H2-receptor antagonists (H2RAs). However, the current treatment guidelines do not provide clear treatment guidance to all the types of healthcare professionals a patient may consult, and treatment decisions vary  Assessing patient perception of treatment using a large observational study will help clinicians make treatment decisions using real-world data.  Our study objective was to assess patient satisfaction with PPIs and H2RAs among a community-based population in the US.
Patients were recruited for this ongoing disease registry from multiple sources including physician, pharmacy and online referrals to a medication monitoring  A random sample of patients reporting using PPIs and H2RAs were invited to complete the Treatment Satisfaction Questionnaire for Medication Version 1.4 Effectiveness
Side Effects
Global Satisfaction
(TSQM)3, a 14-item reliable and valid instrument to assess patients’ satisfaction with medication, providing scores on four scales—Effectiveness, Side Effects, Least Square Means (LsMean) obtained using ANCOVA models after adjusting for patient age, gender, self-reported severity and number of concomitant medications Convenience and Global Satisfaction.
Figure 3. Least Square Means by GERD
Figure 2. Least Square Means by H2RA
 Analyses were conducted to evaluate differences in patient satisfaction across GERD medication class (PPIs vs. H2RAs) and individual medications within Drug Class
each class using analysis of covariance (ANCOVA) models after adjusting for patient age, gender, self-reported severity and number of concomitant medications as well as control for multiple comparisons using the Bonferroni method. Cimetidine
 A total of 1,896 patients comprised the analysis population for this study, of which 1,629 patients were on PPIs, and 267 patients were on H2RAs.
The PPIs included the following medications: esomeprazole (n=498), lansoprazole (n=199), omeprazole (n=690), pantoprazole (n=160) and rabeprazole  The H2RAs included the following medications: cimetidine (n=24), famotidine (n=63) and ranitidine (n=180).  Figures 1 and 2 describe the TSQM scale scores for individual PPIs and H2RAs, respectively. After controlling for covariates and adjusting for multiple comparisons, no significant differences were observed in TSQM scale scores for individual H2RA medications, however some significant differences were observed within PPIs. For example, patients on esomeprazole (p<0.0001), pantoprazole (p=0.0391) and rabeprazole (p=0.0021) had a significantly higher Effectiveness
Side Effects
Side Effects
score on Convenience compared to patients on omeprazole.
 Figure 3 compares the TSQM scale scores between the PPI and H2RA class of drugs. After adjusting for covariates, patients on PPIs had significantly higher Least Square Means (LsMean) obtained using ANCOVA models after adjusting for Least Square Means (LsMean) obtained using ANCOVA models after adjusting for patient age, gender, self-reported severity and number of concomitant medications patient age, gender, self-reported severity and number of concomitant medications scores on Effectiveness (p<0.0001), Convenience (p=0.0007) and Global Satisfaction (p=0.0003) as compared to patients on H2RAs.
 This large observational study found some significant differences in treatment satisfaction with different GERD treatment classes and 1. Sharma P. Wani Sm Yvonne R, Johnson D, Hamilton F. Racial and Geographic Issues in Gastroesophageal Reflux Disease. The American Journal of 2. Tytgat GN, McColl K, Tack J, et al. New Algorithm for the Treatement of Gastroesophageal Reflux Disease. Aliment Pharmacol Ther. 2008; 27: 249–256 This real-world feedback from patients can assist clinicians in making treatment decisions.
3. Atkinson MJ, Sinha A, Hass SL, Colman SS, Kumar RN, Brod M, Rowland CR. Validation of a general measure of treatment satisfaction, the Treatment Satisfaction for Medication (TSQM), using a national panel study of chronic disease. Health and Quality of Life Outcomes. 2004, 2:12 International Society for Pharmacoeconomics and Outcomes Research, 15th Annual International Meeting, May 15-19, 2010, Atlanta, GA, USA


Litigation update

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