DEMOGRAPHIC, SOCIOECONOMIC, AND STRESS FACTORS IN PATIENTS WITH UPPER-GASTROINTESTINAL SYMPTOMS (DYSPEPSIA) - IMPACT ON THE THERAPEUTIC RESPONSE TO CISAPRIDE

This study was undertaken to determine whether demographic, socioecono mic, and/or stress factors are related to symptoms in patients being t reated for upper-gastrointestinal symptoms (dyspepsia); to evaluate a therapeutic trial of cisapride in this group; and to identify which, i f any, of the factors affect the response to treatment. In this open-l abel study, 129 patients with dyspeptic symptoms of at least 4 weeks' duration were treated with cisapride 5 mg three times daily for 4 week s, Each participant completed a questionnaire detailing demographic an d socioeconomic situation, level of mental stress, and life history, S ymptoms were assessed at the beginning and after 4 weeks of treatment, Twenty-seven patients were excluded because of protocol violations (n = 13) and adverse experiences (n = 14), mainly gastrointestinal in na ture. The outcome measures used in this study were the pre- and posttr eatment dyspeptic symptom scores. The initial symptom score and the sc ore change that occurred during treatment were modeled against the fac tors in the questionnaire using a stepwise multiple linear regression model starting with all the variables under investigation. All symptom s were significantly improved after treatment with cisapride (P < 0.00 1), Both the initial total symptom score and the score change were poo rly explained by the regressors. Dividing participants into white and nonwhite race groups resulted in much stronger relationships between r egressors and symptom scores within each group, We concluded that cisa pride was highly effective in relieving dyspeptic symptoms in these st udy groups, Differences between population groups may exist that enabl e the identification of factors accounting for the initial symptom sco re and the response to treatment with cisapride; the overall data, how ever, did not identify such factors, Further investigation with a larg er study group is warranted.