Non-steroidal anti-inflammatory drugs and gastroprotection gap among Family Physicians: Results from a survey
Introduction: Use of non-steroidal anti-inflammatory drugs (NSAIDs) has increased over the last few years and identification of gastrointestinal risk factors is a key factor for prevention of its complications. Even after correct identification of those risk factors, only a small percentage of Family Physicians prescribe gastroprotection. Aims: To knowledge gastrointestinal risk factors and gastroprotections prescription by Family Physicians in patients receiving NSAIDs. Methods: Observational, cross-sectional, random sample study, using a survey among 300 Family Physicians, performed in 2007. Questions were asked about perceived patients rates or hypothetical scenarios and answers were valued on an intention-to-treat basis. The main outcome measure was the gastroprotections prescription rate among patients taking NSAIDs. Results: The perceived proportion of patients receiving NSAIDs was 38% and from these, 40% were taking gastroprotective drugs. The main identified gastrointestinal risk factors were: complicated peptic ulcer (98%), age ≥ 65 years (96%), smoking habits and alcohol consumption (96%), dyspepsia (95%), high-doses of NSAIDs (94%), corticosteroids co-administration (91%) and consumption of two or more NSAIDs (90%). Gastroprotection would be prescribed in 82% of patients with history of complicated peptic ulcer; 60% if receiving two or more or a high dose of NSAIDs; 53% if with Helicobacter pylori infection and 51% if aged ≥ 65 years. For all risk factors, gastroprotection use would be only of 47.3% (95% confidence interval: 45.6-49.0%). Conclusions: Family Physicians are aware of NSAIDs gastrointestinal toxicity but risk estimation seems inadequate since they will not prescribe gastrointestinal protection in more than half the cases.
Main Authors: | , , , |
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Format: | Digital revista |
Language: | English |
Published: |
Sociedade Portuguesa de Gastrenterologia
2013
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Online Access: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-81782013000600003 |
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