A very high rate of inappropriate use of gastroprotection for nonsteroidal anti-inflammatory drug therapy in primary care: a cross-sectional study
| Autor: | Riccardo Marmo, Cesare Hassan, Angelo Zullo, Lara Morelli, Gemma Marotti, Alberto Chiriatti, Diodato Oliveti, Sergio Morini, Diana Anna Elisa Chiuri |
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| Rok vydání: | 2011 |
| Předmět: |
Drug
Adult Male medicine.medical_specialty Adolescent Cross-sectional study Gastrointestinal Diseases media_common.quotation_subject MEDLINE Primary care Young Adult Pharmacotherapy Risk Factors Internal medicine Surveys and Questionnaires medicine Humans Medical prescription Young adult Practice Patterns Physicians' media_common Aged Aged 80 and over Primary Health Care business.industry Anti-ulcer Agent Anti-Inflammatory Agents Non-Steroidal Gastroenterology Middle Aged Anti-Ulcer Agents Cross-Sectional Studies Physical therapy Female business |
| Zdroj: | Journal of clinical gastroenterology. 45(9) |
| ISSN: | 1539-2031 |
| Popis: | To assess the appropriateness of gastroprotection in nonsteroidal anti-inflammatory drug (NSAID) users by primary care physicians.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.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.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% of65-year-old patients without any risk factor. Concomitant therapy with either steroids [odds ratio (OR): 4.3] or anticoagulants (OR: 3.9), and72 years of age (OR: 1.67) were significant predictive factors of inappropriate gastroprotection.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. |
| Databáze: | OpenAIRE |
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