A very high rate of inappropriate use of gastroprotection for nonsteroidal anti-inflammatory drug therapy in primary care: a cross-sectional study.
نویسندگان
چکیده
AIM To assess the appropriateness of gastroprotection in nonsteroidal anti-inflammatory drug (NSAID) users by primary care physicians. BACKGROUND A gastroprotective therapy is advised in NSAID users who are at a high risk for developing gastrointestinal side effects. However, an inappropriate (overuse/underuse) prescription of gastroprotection has been reported. STUDY This was a cross-sectional study in which a questionnaire was administered to consecutive NSAID users who visited routine primary care during a 1-week period. The presence of risk factors for NSAID-related gastrointestinal side effects and the eventual gastroprotective strategy used were registered. Gastroprotective therapy was considered appropriate/inappropriate according to the current guidelines. RESULTS Overall, 869 (25.3%) of 3,433 patients were on chronic NSAID therapy. Gastroprotection was performed in 593 (68.2%) NSAID users, and it was appropriate in only 299 (34.4%) cases. Specifically, an underuse of gastroprotective therapy was observed in 30.6% of ≥65-year-old, whereas an overuse occurred in 57.5% of <65-year-old patients without any risk factor. Concomitant therapy with either steroids [odds ratio (OR): 4.3] or anticoagulants (OR: 3.9), and >72 years of age (OR: 1.67) were significant predictive factors of inappropriate gastroprotection. CONCLUSIONS Appropriate use of gastroprotective therapy for NSAID users by primary care physicians needs to be promptly implemented, as its inappropriate use is noticeably increasing ethical and economic concerns.
منابع مشابه
Utilization of gastroprotective strategies for nonsteroidal anti-inflammatory drug-induced gastrointestinal events in a major teaching hospital
BACKGROUND AND PURPOSE Clinical guidelines recommend the prescribing of gastroprotective strategies in nonsteroidal anti-inflammatory drug (NSAID) users with risk factors for gastrointestinal (GI) ulcer or ulcer complications. However, these guidelines are not often translated into clinical practice. Therefore, the aim of this study was to investigate the utilization of gastroprotective strateg...
متن کاملGastroprotection in NSAID and low-dose aspirin users: a cross-sectional study in primary care.
Gastrointestinal (GI) complications are common side effects related to non-steroidal anti-inflammatory drugs (NSAID) and low-dose aspirin (LDA) use. The guidelines to prevent GI complications establish that patients at high risk should receive gastroprotection. However, different reports have suggested that these strategies are not greatly executed. To determine the prevalence of use of prevent...
متن کاملPersistent nonmalignant pain management using nonsteroidal anti-inflammatory drugs in older patients and use of inappropriate adjuvant medications
OBJECTIVE Due to the high risk of life-threatening side effects, nonsteroidal anti-inflammatory drugs (NSAIDs) are not favored for treating persistent nonmalignant pain in the elderly. We report national prescription trends with determinants of NSAIDs prescription for persistent nonmalignant pain among older patients (age 65 and over) in the US outpatient setting. METHODS A cross-sectional an...
متن کاملIntravenous Immunoglobulin Utilization in a Pediatric Tertiary Care Teaching Hospital in Iran
Intravenous immunoglobulin (IVIG) is an expensive medicine which is widely used for unlabeled indications. We conducted this drug utilization review (DUR) to evaluate the appropriateness of IVIG utilization in Tehran, Iran. This cross sectional study was conducted in a referral pediatric tertiary care hospital in Tehran. During a three month period in 2015, medical records of inpatients with IV...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of clinical gastroenterology
دوره 45 9 شماره
صفحات -
تاریخ انتشار 2011