Underutilization of gastroprotective measures in patients receiving nonsteroidal antiinflammatory drugs.

Smalley W, Stein CM, Arbogast PG, Eisen G, Ray WA, Griffin M
Arthritis Rheum. 2002 46 (8): 2195-200

PMID: 12209525 · DOI:10.1002/art.10425

OBJECTIVE - To determine the frequency of use of recommended gastroprotective strategies in a cohort of patients receiving recurrent treatment with nonsteroidal antiinflammatory drugs (NSAIDs).

METHODS - A cross-sectional study was performed using administrative data from the Tennessee Medicaid (TennCare) program. The study population consisted of 76,765 recurrent recipients of NSAIDs (NSAID users), comprising 24% of the 319,402 persons ages 50 years or older enrolled in the TennCare program from January 1999 through June 2000. Frequency of use of either of 2 recommended gastroprotective strategies, involving either traditional NSAIDs combined with recommended anti-ulcer cotherapy or use of a selective cyclooxygenase 2-inhibiting drug (coxib), was measured and categorized by risk for ulcer complication.

RESULTS - Among this cohort of recurrent NSAID users, 16% received 1 of the 2 recommended gastroprotective therapies: 10% received traditional NSAIDs along with antiulcer drugs at the recommended doses and 6% received coxibs. Among those patients with > or=2 risk factors for ulcer complications (age 75 years or older, peptic ulcer or gastrointestinal bleeding in the past year, or concurrent use of oral anticoagulants or corticosteroids), 30% received such gastroprotective therapy.

CONCLUSION - Use of recommended strategies to decrease ulcer complications in vulnerable populations is relatively uncommon.

MeSH Terms (13)

Anti-Inflammatory Agents, Non-Steroidal Anti-Ulcer Agents Comorbidity Cross-Sectional Studies Cyclooxygenase Inhibitors Digestive System Drug Therapy, Combination Female Humans Male Peptic Ulcer Risk Factors Tennessee

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