Trends in Proton-Pump Inhibitor Use Among Danish Adults: A Nationwide Drug Utilization Study 2015–2023

Abstract

The global increase in proton-pump inhibitor (PPI) use has raised concerns about their appropriate use, particularly due to potential overprescription and associated adverse effects. This study examines PPI utilization patterns among Danish adults from 2015 to 2023 using the Danish nationwide health registries. We estimated the annual incidence rate (users per 100 person-years) and monthly prevalence (proportion with a filled prescription or sufficient tablets). Treatment duration was assessed using the ‘proportion of patients covered’ and the Kaplan–Meier method. We also calculated the proportion of adults with concomitant use of ulcerogenic drugs over time. We identified 1 729 440 adults who filled at least one PPI prescription during 2015–2023. The prevalence increased from 7.0% in 2015 to 8.2% in 2023, while incidence rate remained stable at ~3 users per 100 person years. PPI use increased with age. Three years after initiation, 17% used PPIs, while 1.5% had remained on continuous treatment. In 2023, 50% of users had concomitant ulcerogenic drug use, a 3.2% increase since 2015. The prevalence of PPI use in Denmark has risen markedly reaching a high stable level, with a clear age-dependent trend. Increased attention to appropriate PPI use is necessary to ensure rational prescribing and prevent potential overuse.