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Inadequate use of preventive strategies in patients receiving NSAIDs
I Francetic1, M Bilusic, V Macolic-Sarinic
1Department of Medicine, Clinical Hospital Rebro, Zagreb, Croatia.
Clinical Drug Investigation
|May 26, 2007
Summary
Physician prescribing style, not patient risk, significantly influences the use of gastroprotective drugs with nonsteroidal anti-inflammatory drugs (NSAIDs). This highlights a gap in evidence-based prescribing for NSAID-associated gastrointestinal toxicity prevention.
Area of Science:
- Gastroenterology
- Pharmacology
- Clinical Medicine
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used but carry a risk of gastrointestinal toxicity.
- Gastroprotective drugs are often prescribed concurrently to mitigate these risks.
- Factors influencing the co-prescription of NSAIDs and gastroprotective agents remain unclear.
Purpose of the Study:
- To assess the prevalence of gastroprotective drug use in patients taking NSAIDs.
- To identify patient risk factors for NSAID-induced gastrointestinal toxicity.
- To determine the influence of patient risk and physician preference on prescribing gastroprotective strategies.
Main Methods:
- Observational study of 109 hospitalized adult patients.
- Data collected on NSAID and gastroprotective drug use.
- Assessment of patient risk factors for gastrointestinal toxicity and physician prescribing patterns.
Main Results:
- 66% of patients on gastroprotective drugs with NSAIDs had no identifiable risk factors.
- 29% of NSAID users with risk factors were not prescribed gastroprotective agents.
- Physician prescribing preference (OR 6.40) was a stronger predictor of gastroprotective use than patient risk factors (OR 1.25).
Conclusions:
- Physician prescribing habits are the primary determinant for initiating gastroprotective strategies in NSAID users.
- Current prescribing practices do not fully align with patient risk stratification for gastrointestinal toxicity.
- There is a need to emphasize evidence-based guidelines in NSAID and gastroprotective drug co-prescription.
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