Inadequate Use of Preventive Strategies in Patients Receiving NSAIDs
| Autor: | Iveta Merćep, Suzana. Mimica, Ines Baotić, Viola Macolic-Sarinic, Igor Francetić, Ksenija Makar-Aušperger, Petra Simic, Mirjana Huić, Marinko Bilušić, Viktorija Erdeljić |
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| Rok vydání: | 2005 |
| Předmět: |
Drug
medicine.medical_specialty business.industry media_common.quotation_subject Alternative medicine General Medicine Odds ratio Nonsteroidal anti inflammatories NSAID induced gastrointestinal damage Misoprostol Histamine H2 receptor antagonists Proton pump inhibitors Drug utilisation Prescribing digestive system diseases Surgery Odds Pharmacotherapy Internal medicine Concomitant medicine Pharmacology (medical) Observational study In patient business media_common |
| Zdroj: | Clinical Drug Investigation. 25:265-270 |
| ISSN: | 1173-2563 |
| DOI: | 10.2165/00044011-200525040-00006 |
| Popis: | Objective: Little is known about the factors that influence the decision to use NSAIDs in combination with gastroprotective drugs. The aims of this observational study were to evaluate the extent to which NSAID users are prescribed concomitant gastroprotective drug regimens (‘preventive strategies’), and to determine how patient risk factors for NSAID-associated gastrointestinal toxicity and physician prescribing preferences influenced the decision to prescribe a gastroprotective drug in combination with an NSAID. Design and patients: The study was conducted on 29 June 2004 and comprised 109 eligible adult patients hospitalised at the Clinical Hospital Center, Zagreb. Use of NSAIDs and gastroprotective drugs, risk factors for NSAID-associated gastrointestinal toxicity, and physician prescribing preferences were monitored throughout the study. Results: Sixty-six percent of patients receiving proton pump inhibitors or histamine H2-receptor antagonists with NSAIDs had no risk factors for gastrointestinal toxicity. Furthermore, 29% of patients who used NSAIDs had risk factors for gastrointestinal toxicity but were not receiving gastroprotective drugs. Even though patients at risk of NSAID-associated gastrointestinal complications had higher odds of receiving preventive strategies (odds ratio 1.25), the absolute rate of utilisation of these therapies in at-risk populations was unacceptably low (69%). However, the strongest independent correlation for gastroprotective drug use was the prescribing physician, with an odds ratio of 6.40. Conclusion: This study demonstrates that an individual physician’s prescribing style largely determines the odds of receiving preventive strategies with NSAID treatment and is more important than the patient’s risk factors for gastrointestinal toxicity. |
| Databáze: | OpenAIRE |
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