Criteria used by general practitioners in prescribing prokinetic or antisecretory drugs in patients with functional dyspepsia

Objective: to analyze the clinical factors considered by general practition ers for the prescription of prokinetic or antisecretory drugs in patients w ith functional dyspepsia (FD), and to assess therapeutic outcomes and facto rs predicting effectiveness. Design: multicentric, prospective and observational study. Patients: 1,021 patients with FD were included, One hundred and thirty-two (132) were excluded from the analysis because they were taking ASA or NSAID . Patients were classified according to their predominant symptoms as reflu x, ulcer, dysmotility, or non-specific. At the physician discretion, treatm ent with alkali drugs was prescribed to 38 patients, prokinetic drugs to 57 4, antisecretory drugs to 123 and a combined therapy to 154. One month late r, patient self-perception of symptomatic improvement was evaluated in pati ents treated with prokinetic drugs and antisecretory drugs. Results: 85% of the patients reported symptomatic improvement after one mon th of treatment. Patients with non-specific FD had lower improvement rates regardless of the drug used (prokinetic or antisecretory) (77%) compared to all the other types (p = 0.03). Prescription of prokinetics was associated to female gender (OR: 0.43; 95% Cl: 0.28-0.66) and early satiety (OR: 2.5; 95% Cl: 1.6-4.1). A longer symptomatic evolution (OR 0.92: 95% Cl: 0.88-0. 97) was the only independent predictive factor of a poor response to prokin etic drugs. Conclusions: among patients with FD attended by general practitioners, fema le gender and early satiety symptom were associated to the prescription of prokinetic drugs. Early symptomatic effectiveness rates for prokinetic or a ntisecretory drugs alike were high (85%). Patients with non-specific dyspep sia or long symptomatic evolution showed less favorable symptomatic respons e to prokinetic drugs.