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Time‐trends in gastroprotection with nonsteroidal anti‐inflammatory drugs (NSAIDs)
Author(s) -
VALKHOFF V. E.,
VAN SOEST E. M.,
STURKENBOOM M. C. J. M.,
KUIPERS E. J.
Publication year - 2010
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2010.04281.x
Subject(s) - medicine , medical prescription , aspirin , nonsteroidal , risk factor , population , pharmacology , environmental health
Aliment Pharmacol Ther 31 , 1218–1228 Summary Background Preventive strategies are advocated in patients at risk of upper‐gastrointestinal complications associated with nonsteroidal anti‐inflammatory drugs (NSAIDs). Aim To examine time‐trends in preventive strategies. Methods In a study population comprising 50 126 NSAID users ≥50 years from the Integrated Primary Care Information database, we considered two preventive strategies: co‐prescription of gastroprotective agents and prescription of a cyclooxygenase‐2‐selective inhibitor. In patients with ≥1 risk factor (history of upper‐gastrointestinal bleeding/ulceration, age >65 years, use of anticoagulants, aspirin, or corticosteroids), correct prescription was defined as the presence of a preventive strategy and under‐prescription as the absence of one. In patients with no risk factors, correct prescription was defined as the lack of a preventive strategy, and over‐prescription as the presence of one. Results Correct prescription rose from 6.9% in 1996 to 39.4% in 2006 ( P < 0.01) in high‐risk NSAID users. Under‐prescription fell from 93.1% to 59.9% ( P < 0.01). In the complete cohort, over‐prescription rose from 2.9% to 12.3% ( P < 0.01). Conclusions Under‐prescription of preventive strategies has steadily decreased between 1996 and 2006; however, 60% of NSAID users at increased risk of NSAID complications still do not receive adequate protection.