Forty-seven patients who met inclusion and exclusion criteria participated in the project. Thirteen patients either did not have a telephone or were not willing to take part in the project. The remaining 34 patients were contacted by telephone and were subsequently stepped down to lansoprazole canadian administered once a day.
Participants were between the ages of 46 and 83 years (mean + SD, 64 + 10.5 years), and most were men (97%). The body mass index (BMI) of the 32 patients, with a recorded height and weight, ranged from 19 to 42 kg/m2 (mean + SD, 28 + 5.5 kg/m2). The length of treatment with a PPI prior to step-down treatment had ranged from four to 38 months (mean + SD, 23 + 10.2 months). A review of the medication profile revealed that 24 patients (71%) were receiving concomitant drug therapy, including calcium channel blockers, exogenous hormone therapy, and theophylline, that was known to relax lower esophageal sphincter (LES) tone, thereby leading to an increase in GERD symptoms.
Twenty-two patients (65%) reported no increased frequency of GERD symptoms during the two-week follow-up call. Four patients (12%) required the addition of ranitidine tablet after experiencing heartburn during the overnight hours. Eight patients (23%) resumed and maintained the twice-daily dose of lansoprazole prior to the follow-up call and could not specify the number of times a day they had experienced heartburn, which they felt was continual throughout the day.
Table 2 Follow-up Results of Patients Undergoing Step-Down Treatment from Twice-Daily Lansoprazole medication
|Once-Daily PPI No. (%)||Once-Daily PPI + Bedtime H2RANo. (%)||Twice-DailyPPI
|2 weeks 4 weeks||22 (65%) 21 (62%)||4 (12%) 3 (9%)||8 (23%) 10 (29%)|
|HjRA = histamine receptor antagonist; PPI = proton pump inhibitor.|
At the four-week follow-up, one patient (3%) who had previously been started on a bedtime dose of ranitidine canadian resumed taking lansoprazole twice daily after symptoms increased from nightly to continuous throughout the day. A total of 10 patients (29%) resumed twice-daily PPIs by the four-week follow-up call. Twenty-one patients (62%) remained symptom-free taking once-daily doses throughout the monitoring period (Table 2).