Use of gastroprotective drugs in patients receiving low-dose aspirin

Low-dose aspirin is widely used for prevention of stroke, heart attacks, and death in patients with atherothrombotic disease, but its use is associated with serious gastrointestinal (GI) adverse effects. Gastroprotective drugs (GPDs) have been used to reduce aspirin-related GI complications but are usually underutilized. The aim of this study was therefore to determine the prescription pattern of GPDs with low-dose aspirin therapy.

All patients who had attended general and specialist outpatient clinics of Tung Wah Hospital between September 1, 2007 and September 30, 2007 and received low-dose aspirin therapy were included in the study. Data were collected through retrospective chart review and recorded on a standardized data collection form. Univariate analysis was performed using chi2 tests for discrete variables. Factors that might be associated with prescription of GPD with low-dose aspirin were assessed in multiple logistic regression models.

Three hundred and three patients were included in this study, and the rate of GPD prescription was 48.5%. Most of the patients received H2-receptor antagonist, and, to a lesser degree, antacid and proton pump inhibitor. Patients with history of GI ulcer/bleeding were much more likely to be co-prescribed GPD than those who had no history of GI disorders (OR, 26.5). Compared with patients who were managed in general outpatient clinic, those managed in specialist clinic were more likely to receive GPD (OR, 3.04).

The prescription rate of GPD with aspirin is low. Also, it seems that physicians are unaware of the risk factors related to aspirin-induced GI complications.