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Nonsteroidal antiinflammatory drug use among patients with GI bleeding.
Ann Pharmacother. 2004 Jul-Aug; 38(7-8):1159-64.AP

Abstract

BACKGROUND

Previous studies have suggested that recommended gastroprotective strategies such as gastroprotective agents (GPAs) and cyclooxygenase (COX) 2 inhibitors may be underutilized among individuals at risk for nonsteroidal antiinflammatory drug (NSAID)-related gastrointestinal (GI) bleeding.

OBJECTIVE

To examine the use of traditional NSAIDs, COX-2 inhibitors, and GPAs among patients recently hospitalized for GI bleeding.

METHODS

This was a retrospective cohort study of a national sample of 4338 veterans hospitalized for GI bleeding between January and June 1999. Prescription drug use was examined for 6 months following hospitalization. We examined relationships of subject characteristics (age, race, gender, geographic region, diagnosis of arthritis) to prescription of a high-risk NSAID, defined as a traditional NSAID but no GPA within 60 days before or after the NSAID.

RESULTS

Approximately 20% of subjects were prescribed an NSAID or COX-2 inhibitor, but only 5% were prescribed a traditional NSAID with no GPA. In a multivariable analysis, subjects <65 years of age and those with arthritis were more likely to be prescribed a traditional NSAID without a GPA. No other subject characteristics were related to receipt of a high-risk prescription.

CONCLUSIONS

In a national sample of veterans with a recent hospitalization for GI bleeding, high-risk NSAID prescriptions were uncommon. Underuse of gastroprotective strategies may be more common in patients with less recent GI bleeding-related hospitalization. Strategies to remind physicians and pharmacists to screen for GI risk factors may help to sustain appropriate prescribing and reduce NSAID-related adverse events.

Authors+Show Affiliations

Center for Health Services Research in Primary Care, Veterans Affairs Medical Center (VAMC), Durham, NC 27705-3897, USA. domin004@mc.duke.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

15187205

Citation

Dominick, Kelli L., et al. "Nonsteroidal Antiinflammatory Drug Use Among Patients With GI Bleeding." The Annals of Pharmacotherapy, vol. 38, no. 7-8, 2004, pp. 1159-64.
Dominick KL, Bosworth HB, Jeffreys AS, et al. Nonsteroidal antiinflammatory drug use among patients with GI bleeding. Ann Pharmacother. 2004;38(7-8):1159-64.
Dominick, K. L., Bosworth, H. B., Jeffreys, A. S., Grambow, S. C., Oddone, E. Z., & Horner, R. D. (2004). Nonsteroidal antiinflammatory drug use among patients with GI bleeding. The Annals of Pharmacotherapy, 38(7-8), 1159-64.
Dominick KL, et al. Nonsteroidal Antiinflammatory Drug Use Among Patients With GI Bleeding. Ann Pharmacother. 2004 Jul-Aug;38(7-8):1159-64. PubMed PMID: 15187205.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonsteroidal antiinflammatory drug use among patients with GI bleeding. AU - Dominick,Kelli L, AU - Bosworth,Hayden B, AU - Jeffreys,Amy S, AU - Grambow,Steven C, AU - Oddone,Eugene Z, AU - Horner,Ronnie D, Y1 - 2004/06/08/ PY - 2004/6/10/pubmed PY - 2004/10/7/medline PY - 2004/6/10/entrez SP - 1159 EP - 64 JF - The Annals of pharmacotherapy JO - Ann Pharmacother VL - 38 IS - 7-8 N2 - BACKGROUND: Previous studies have suggested that recommended gastroprotective strategies such as gastroprotective agents (GPAs) and cyclooxygenase (COX) 2 inhibitors may be underutilized among individuals at risk for nonsteroidal antiinflammatory drug (NSAID)-related gastrointestinal (GI) bleeding. OBJECTIVE: To examine the use of traditional NSAIDs, COX-2 inhibitors, and GPAs among patients recently hospitalized for GI bleeding. METHODS: This was a retrospective cohort study of a national sample of 4338 veterans hospitalized for GI bleeding between January and June 1999. Prescription drug use was examined for 6 months following hospitalization. We examined relationships of subject characteristics (age, race, gender, geographic region, diagnosis of arthritis) to prescription of a high-risk NSAID, defined as a traditional NSAID but no GPA within 60 days before or after the NSAID. RESULTS: Approximately 20% of subjects were prescribed an NSAID or COX-2 inhibitor, but only 5% were prescribed a traditional NSAID with no GPA. In a multivariable analysis, subjects <65 years of age and those with arthritis were more likely to be prescribed a traditional NSAID without a GPA. No other subject characteristics were related to receipt of a high-risk prescription. CONCLUSIONS: In a national sample of veterans with a recent hospitalization for GI bleeding, high-risk NSAID prescriptions were uncommon. Underuse of gastroprotective strategies may be more common in patients with less recent GI bleeding-related hospitalization. Strategies to remind physicians and pharmacists to screen for GI risk factors may help to sustain appropriate prescribing and reduce NSAID-related adverse events. SN - 1060-0280 UR - https://www.unboundmedicine.com/medline/citation/15187205/Nonsteroidal_antiinflammatory_drug_use_among_patients_with_GI_bleeding_ L2 - https://journals.sagepub.com/doi/10.1345/aph.1E052?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -