Awareness, attitudes, and clinical utilization of vonoprazan for Helicobacter pylori infection and gastroesophageal reflux disease among Chinese physicians: a nationwide cross-sectional study.

backgroundVonoprazan has been introduced as an alternative to proton pump inhibitors (PPIs) for Helicobacter pylori (H. pylori) infection and gastroesophageal reflux disease (GERD). Despite regulatory approval and guideline inclusion in China, physician awareness, clinical utilization, and perceived barriers are not well described. This study aimed to assess the awareness, clinical utilization, and attitudes toward vonoprazan among Chinese physicians.

methodsA nationwide cross-sectional, web-based survey was conducted among Chinese physicians between December 2024 and February 2025. Eligible participants included gastroenterologists, internists, and general practitioners. The 30-item survey captured clinician demographics, knowledge of vonoprazan, prescribing patterns, perceived advantages and limitations, and potential future indications. Descriptive statistics and subgroup analyses were performed. Multivariable logistic regression identified factors associated with vonoprazan use. Statistical significance was set at p < 0.05.

results361 physicians completed the survey. Among them, 54.8% were resident physicians, 32.7% were attending physicians, 53.7% were women, and 70.1% practiced in tertiary hospitals. Overall, 27.1% were well informed about vonoprazan, 41.3% had heard of it but were unfamiliar, and 31.6% had never heard of it. Vonoprazan use was reported by 11.9% of respondents for H. pylori eradication and 10.5% for GERD management. Utilization was significantly higher among gastroenterologists and physicians working in secondary or tertiary hospitals (p < 0.05). In multivariable logistic regression, physicians from internal medicine (non-gastroenterology) (OR 0.35, 95% CI 0.15-0.77), surgical departments (OR 0.33, 95% CI 0.15-0.69), and those with lower awareness (OR 0.25, 95% CI 0.13-0.46) were significantly less likely to use vonoprazan. The main perceived advantages of vonoprazan were greater efficacy (59.1%), durable acid suppression (48.6%), and faster onset (40.9%). Key barriers to its use included preference for PPIs (51.0%), lack of hospital formulary approval (40.2%), limited local data (21.6%), and high cost (18.6%).

conclusionsIn this national sample, Chinese physicians demonstrated moderate awareness but limited real-world use of vonoprazan for H. pylori infection and GERD. Utilization was largely confined to tertiary centers and gastroenterology specialists. Broader educational initiatives, inclusion in hospital formularies, reimbursement alignment, and generation of real-world evidence may help facilitate appropriate and equitable adoption of vonoprazan in clinical practice.