Assessing NSAID prescription use as a predisposing factor for gastroesophageal reflux disease in a Medicaid population

Purpose. The purpose of the study was to determine the incidence of GERD as sociated with prescription NSAID consumption. Methods. All Georgia Medicaid patients > 25 years of age and continuously e ligible for 1996, 1997, and 1998 were included in the study. Patients were excluded if they received a GERD diagnoses during 1996 and 1997. Patients w ere observed in 1998 and classified into GERD and control cohorts. Comorbid ities, demographics, and NSAID prescription consumption were retained and m odeled with logistic regression. Results. The absolute risk of developing GERD without previous NSAID consum ption was 0.38. The absolute risk of developing GERD for those patients who consumed one or more NSAID prescriptions during 1996 and 1997 was 0.80. Th us, the relative risk of GERD for NSAID patients was 2.11. GERD was signifi cantly associated with one or more NSAID prescriptions (OR = 1.82), age (OR = 1.05 for 5 year range), gender (OR = 1.31 for females), asthma (OR = 3.2 4), obesity (OR = 2.77), hiatal hernia (OR = 4.17), tobacco use (OR = 2.56) , and alcohol (OR = 1.83). The initial NSAID prescription was responsible f or the greatest marginal increase in GERD. Conclusions. Our study suggests that NSAIDs are associated with GERD especi ally for females, alcohol and tobacco users, and patients with asthma, hiat al hernia, or obesity.