ABSTRACT
Background: Dyspepsia includes a spectrum of symptoms ranging from epigastric pain and early satiety to postprandial fullness. The worldwide prevalence of dyspepsia is 20–30%. It is slightly higher in the Western population and occurs more frequently among women. While the precise prevalence of dyspepsia in India is not available, different studies estimate that it affects 7.6–49% of the Indian population. Through our current study, we wanted to understand the demographics, clinical profile, patient presentation, and management in India. We also wanted to document the pattern of use of proton pump inhibitors (PPI) and patient satisfaction with PPIs in Indian patients with dyspepsia. Materials and methods: This pan-India, multi-centric, cross-sectional, questionnaire-based, noninterventional, observational study was conducted between February and October 2021 in patients >18 years of age with a clinical diagnosis of any form of dyspepsia. Descriptive statistics were used for categorical variables, and between-group comparisons were made using Fischer’s exact test, with p < 0.05 denoting statistical significance. Results: A total of 3,739 patients from across 29 states of India participated in the study. Most of the patients were male (70.8%) and were from urban areas (56.8%). The highest percentage of patients were aged 31–40 (33.8%), and most patients (60.2%) had dyspepsia for a duration of 6–12 months. Patients with functional dyspepsia (FD) (78.5%) were significantly higher compared to organic dyspepsia (OD) (21.5%) (p < 0.001). The most frequent presenting symptoms were epigastric pain, nausea, vomiting, and heartburn. A quarter (25.6%) of the dyspepsia patients were associated with various comorbid conditions, of which diabetes mellitus, hypertension, and irritable bowel syndrome are the most common ones. A total of 619 patients in the study were on concomitant medications, of which the most common were antidiabetic drugs (271/619, 43.8%). Rabeprazole was the most frequently used PPI (2467/3739, 66.0%) among the study participants. The patient satisfaction analysis showed that, overall, patients were satisfied with PPIs, as most patients (~80%) agreed to almost all questions. The analysis for individual PPIs showed the highest “agree” responses in the rabeprazole group for almost all questions (12 of 13). Around 86.4% of patients on rabeprazole agreed with “immediate relief from acidity,” 84.9% for “gives me complete relief,” and 85.9% for “relief from nighttime acidity symptoms.” Conclusion: Our study involving over 3,700 Indian patients with Dyspepsia adds to the growing knowledge of dyspepsia in India. Dyspepsia is more prevalent in males and in the 31–50 age group. FD is the most common form. Overall, patients were satisfied with PPIs in dyspepsia management in India. Patients on rabeprazole showed higher levels of medication adherence, satisfaction with symptom relief, convenience of therapy, and safety compared to patients on other PPIs. Against the backdrop of a paucity of reliable data about dyspepsia in India, our study results provide valuable insights into Dyspepsia and its management in an Indian setting
ABSTRACT
Background: Tetracyclines, in particular doxycycline, are recommended for the treatment of patients with acute undifferentiated febrile illness (AUFI); however, real-world studies are scarce. Methods: This retrospective, multicenter, observational study reviewed electronic medical records (April 2018 to March 2021) of adult patients (outpatient and inpatient departments [OPD and IPD]) with AUFI, treated with doxycycline monotherapy (doxycycline group) or doxycycline in combination with other antimicrobials (combination therapy group), from 7 tertiary hospitals and clinics in India. Results: Overall, 473 patients were included; 73.8% and 26.2% patients were prescribed doxycycline alone or in combination with other antimicrobials, respectively. Defervescence was achieved in 65.6% and 57.3% patients, respectively at the second (8-14 days) follow-up visit. Clinical cure rate for symptomatic resolution varied between 89.6% and 100% in OPD settings. Time taken from treatment initiation to defervescence was 3.51 ± 3.16 days for the doxycycline group and 3.46 ± 3.07 days for the combination therapy group. Both groups showed improvements in body temperature in OPD settings (84.2% and 84.5%) as well as IPD settings (97.4% and 94.1%). Adverse events in OPD patients in both groups were nausea (7.8% and 8.7%), anorexia (1.6% and 33.0%) and dyspepsia (1.6% and 67.9%). Conclusion: Doxycycline appears to be a promising candidate for treating patients with AUFI due to its demonstrated real-world effectiveness and safety profile.
ABSTRACT
Goal : This is a subjective survey to assess the knowledge, awareness, and practices (KAP) of physicians while prescribing Proton pump inhibitors (PPI) in acid peptic disorder (APD) patients in India. Background : APD represents a variety of gastric anomalies in which PPIs form the mainstay of management. Many of the APD patients are associated with comorbidities, resulting in polypharmacy and increased risk of drugdrug interactions. Therefore, it is essential that physicians be aware of PPI drug interactions while prescribing them to patients with comorbidities. In developing countries like India, studies assessing the KAP of Physicians are limited. Study Design : This questionnaire-based study consisted of 3 domains: (A) Study objectives and consent; (B) Participants’ socio-demographic details; (C) Questions on KAP of Physicians around various aspects of APD management and PPI usage. Results : A total of 110 Physicians completed the survey. 92% observed stress as the most common risk factor; Obesity (46), Diabetes Mellitus (41%) and Cardiovascular Disease (33%) as the most frequent comorbidities, in APD. Almost all Physicians (99%) considered patient’s comorbidity important while choosing PPI. 84% participants felt that anticoagulants when co-prescribed with PPI have higher chance of drug-drug interactions. 60% ranked Rabeprazole in the top, in terms of safety and tolerability among PPIs. Conclusion: The present study mapped the awareness of Indian Physicians on APD, PPI usage, their adverse effects, drug-drug interactions; patient compliance and satisfaction with PPIs. These findings can be used to plan future interventions targeting HCPs, to ensure safe and appropriate use of PPIs