Quality standard
Quality statement 6: Acid‑suppressing drugs
Quality statement 6: Acid‑suppressing drugs
Quality statement
Infants and children are not prescribed acid‑suppressing drugs if visible regurgitation is an isolated symptom.
Rationale
There is no evidence that acid‑suppressing drugs such as proton pump inhibitors (PPIs) or H2 receptor antagonists (H2RAs) are effective in reducing regurgitation in infants and children. They are generally well tolerated but do have potential adverse effects, and unnecessary use should be avoided.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements to ensure that infants and children with regurgitation as an isolated symptom are not prescribed acid‑suppressing drugs.
Data source: Local data collection.
Process
Proportion of infants and children presenting with regurgitation as an isolated symptom prescribed acid‑suppressing drugs.
Numerator – number in the denominator prescribed acid‑suppressing drugs.
Denominator – number of infants and children presenting with regurgitation as an isolated symptom.
Data source: Local data collection.
What the quality statement means for different audiences
Service providers (secondary care, community care providers, GP practices) ensure that there are practice arrangements and written clinical protocols to ensure that infants and children with regurgitation as an isolated symptom are not prescribed acid‑suppressing drugs.
Healthcare professionals (midwives, paediatric nurses or GPs) do not prescribe acid‑suppressing drugs to infants and children with regurgitation as an isolated symptom.
Commissioners (clinical commissioning groups and NHS England) ensure that services they commission do not prescribe acid‑suppressing drugs to infants and children with regurgitation as an isolated symptom.
Infants and children who regurgitate food but have no other symptoms are not prescribed medicines that reduce acid production in the stomach.
Source guidance
Gastro-oesophageal reflux disease in children and young people. NICE guideline NG1 (2015, updated 2019), recommendation 1.3.1 (key priority for implementation)
Definitions of terms used in this quality statement
Acid-suppressing drugs
Acid-suppressing drugs are a group of medications that reduce gastric acid secretion. They include H2RAs and PPIs. [NICE's full guideline on gastro-oesophageal reflux disease in children and young people]