Using the method of pragmatic modeling to explore long-term management of gastroparesis in a large Gastroparesis Clinical Research Consortium (GpCRC) database, domperidone therapy led to moderately but considerable improvement in symptoms of gastroparesis. Investigators undertook this study to assess the effect of domperidone treatment for people taking part in National Institute of Diabetes and Digestive and Kidney Diseases GpCRC Registries.

The GpCRC cohort in this dynamic cohort study comprised of people with gastroparesis (75%) and with gastroparesis-like symptoms but having normal gastric emptying (25%). The domperidone group commenced therapy during the 96 weeks of recruitment in GpCRC Registry 2 and GpCRC Registry 1. Subjects who had previously taken or who were on domperidone therapy at recruitment were eliminated from the study. The control group/non-domperidone group did not use domperidone prior to or following recruitment.

The study endpoints ascertained were alteration from baseline in Gastroparesis Cardinal Symptom Index (GCSI) total score, with three subscales, plus Patient Assessment of Upper Gastrointestinal Disorders-Quality of Life (PAGI-QoL) score and Gastroesophageal Reflux Disease (GERD) score. Out of 748 patients, 181 participants were in the domperidone group, and 567 participants were in the non-domperidone group. Notably, 63% of people had idiopathic gastroparesis.

At baseline, domperidone recipients compared to non-domperidone recipients were considerably younger, had decreased body mass index, an increased annual household income, non-Hispanic ethnicity, lower narcotic utilization, lower supplemental and complementary medication usage, and were highly susceptible have delayed gastric emptying time, and worsened nausea and fullness scores.

In comparison with the non-domperidone group, the domperidone group witnessed moderate but considerably more improvement in gastroparesis outcome measures: GCSI total score, nausea, and fullness subscales, upper abdominal pain score, GERD score, and PAGI-QoL score.