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Inadequate prevention of NSAID-induced gastrointestinal events.
Ann Pharmacother. 2004 May; 38(5):760-3.AP

Abstract

BACKGROUND

Use of nonsteroidal antiinflammatory drugs (NSAIDs) is a well-known cause of gastrointestinal (GI) adverse events. To protect patients at risk, several strategies are advised, including concomitant treatment with proton-pump inhibitors or switching to cyclooxygenase (COX)-2 selective NSAIDs. It is as yet unknown how many patients at risk for NSAID-induced events are protected.

OBJECTIVE

To estimate the number of patients using GI preventive treatment while at risk for NSAID-induced GI events.

METHODS

Records of patients using NSAIDs consecutively for at least 100 days (from 2001 to 2002) were obtained from the PHARMO system in the Netherlands (N = 1,000,000). GI preventive treatments were classified as adequate or inadequate based on evidence-based criteria. Adequate treatment was defined as concomitant use of misoprostol (>400 microg daily), histamine2-antagonists (> or =2 times recommended dose) or proton-pump inhibitors (> or =1 recommended dose), or alternative treatment with COX-2 selective inhibitors.

RESULTS

A total of 10,121 patients met the study inclusion criteria; 70% were women. One or more preventive strategies were prescribed in 4340 patients (42.9%), of which 2799 (64.5%) were adequate and 1541 (35.5%) inadequate. Prescribing of adequate preventive treatments increased with the number of risk factors, from 13.3% among those with no additional risk factors to 61.9% for those with > or =4 risk factors.

CONCLUSIONS

Although risk factors for GI damage were recognized, a large number of patients in the Netherlands were not or were inadequately protected against potential NSAID-associated GI damage. Despite recommendations, and even in the presence of > or =4 risk factors, almost 40% of these patients were not prescribed adequate GI preventive treatment.

Authors+Show Affiliations

PHARMO Institute for Drug Outcomes Studies, Utrecht, Netherlands. Ron.Herings@PHARMO.NLNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15031416

Citation

Herings, Ron M C., and Wim G. Goettsch. "Inadequate Prevention of NSAID-induced Gastrointestinal Events." The Annals of Pharmacotherapy, vol. 38, no. 5, 2004, pp. 760-3.
Herings RM, Goettsch WG. Inadequate prevention of NSAID-induced gastrointestinal events. Ann Pharmacother. 2004;38(5):760-3.
Herings, R. M., & Goettsch, W. G. (2004). Inadequate prevention of NSAID-induced gastrointestinal events. The Annals of Pharmacotherapy, 38(5), 760-3.
Herings RM, Goettsch WG. Inadequate Prevention of NSAID-induced Gastrointestinal Events. Ann Pharmacother. 2004;38(5):760-3. PubMed PMID: 15031416.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inadequate prevention of NSAID-induced gastrointestinal events. AU - Herings,Ron M C, AU - Goettsch,Wim G, Y1 - 2004/03/18/ PY - 2004/3/20/pubmed PY - 2004/8/25/medline PY - 2004/3/20/entrez SP - 760 EP - 3 JF - The Annals of pharmacotherapy JO - Ann Pharmacother VL - 38 IS - 5 N2 - BACKGROUND: Use of nonsteroidal antiinflammatory drugs (NSAIDs) is a well-known cause of gastrointestinal (GI) adverse events. To protect patients at risk, several strategies are advised, including concomitant treatment with proton-pump inhibitors or switching to cyclooxygenase (COX)-2 selective NSAIDs. It is as yet unknown how many patients at risk for NSAID-induced events are protected. OBJECTIVE: To estimate the number of patients using GI preventive treatment while at risk for NSAID-induced GI events. METHODS: Records of patients using NSAIDs consecutively for at least 100 days (from 2001 to 2002) were obtained from the PHARMO system in the Netherlands (N = 1,000,000). GI preventive treatments were classified as adequate or inadequate based on evidence-based criteria. Adequate treatment was defined as concomitant use of misoprostol (>400 microg daily), histamine2-antagonists (> or =2 times recommended dose) or proton-pump inhibitors (> or =1 recommended dose), or alternative treatment with COX-2 selective inhibitors. RESULTS: A total of 10,121 patients met the study inclusion criteria; 70% were women. One or more preventive strategies were prescribed in 4340 patients (42.9%), of which 2799 (64.5%) were adequate and 1541 (35.5%) inadequate. Prescribing of adequate preventive treatments increased with the number of risk factors, from 13.3% among those with no additional risk factors to 61.9% for those with > or =4 risk factors. CONCLUSIONS: Although risk factors for GI damage were recognized, a large number of patients in the Netherlands were not or were inadequately protected against potential NSAID-associated GI damage. Despite recommendations, and even in the presence of > or =4 risk factors, almost 40% of these patients were not prescribed adequate GI preventive treatment. SN - 1060-0280 UR - https://www.unboundmedicine.com/medline/citation/15031416/Inadequate_prevention_of_NSAID_induced_gastrointestinal_events_ L2 - https://journals.sagepub.com/doi/10.1345/aph.1D068?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -