PONE-D-21-04933

Proton pump inhibitor and community pharmacies: usage profile and factors associated with long-term use

PLOS ONE

Dear Dr. Martins,

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Sanjiv Mahadeva, MRCP, MD

Academic Editor

PLOS ONE

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the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.'

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Additional Editor Comments (if provided):

The study lacks novelty, but is reasonably well presented. The authors need to respond to the Reviewer's comments.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: No

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for the submission. However, I believe that the manuscript does not have sufficient international interest, novelty and scientific rigour for publication in PLOS ONE. It would add nothing new to the literature. There have been dozens of better studies examining long-term PPI use. There is an implication here in the introduction section that the study is solely examining the OTC use of PPIs without prescription, but that does not seem to be the case at all.

How many patients declined to complete the survey, of those approached? Details of the statistical methods are inadequate e.g. How was the issue of collinearity/multicollinearity in the multivariate statistical analyses dealt with (assessed and appropriately managed)?

The assessment of appropriateness of long-term therapy is also markedly inadequate. Judging against licensed indications is certainly not sufficient. There should be assessment against relevant international or national guidelines specific to the indications accepted as clinically appropriate for the long-term use of these drugs (many such guidelines exist).

Reviewer #2: Thank you for inviting me to review this manuscript which describes the use of PPI in community pharmacy, and the factors associated with it.

Overall, the manuscript is well written. However, I have a few comments that could perhaps improve the quality of the manuscript.

Methods

Please provide more details on how participants were recruited. The authors did not mention that it was only from one pharmacy chain on lines 90-94, but later mentioned this as a limitation that only one chain pharmacy was approached. Also, it was not explained how the four districts in the city were represented, since there will be international readers who will be reading this manuscript. How was the inclusion of the number of participants ensured that it was approximately proportional to the population of each district?

Data analysis

Was data normally distributed? if no, then non parametric tests should be used.

Results

Table 1: what does 0-5 salaries mean?

Also, the column of the table should specify that it is n and %. For continuous variables, it should be presented as 54.1+/- 17.9, rather than in columns. 95% CI values not need for categorical variables. only for the multiple logistic regression table. Also for self reported diseases, suggest to just report the top 3 diseases, and medication ATC class

Line 126: Should avoid using the word "stand out"

Discussion

Should include a para on the long term effects of PPI, and the role of community pharmacists in this?

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Reviewer #1: No

Reviewer #2: Yes: Pauline Siew Mei Lai

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Proton pump inhibitor and community pharmacies: usage profile and factors associated with long-term use

PONE-D-21-04933R1

Dear Dr. Martins,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Sanjiv Mahadeva, MRCP, MD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

The authors have responded satisfactorily to the 2 original reviewers comments.

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: No

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: Normality of data should be performed regardless, and if found to be not normally distributed, data should be presented as median and interquartile range instead of mean and SD. Otherwise, the authors have addressed all comments appropriately.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No