[Gastrointestinal bleeding and potentially inappropriate medication by NSAIDs]

Area of Science:

• Geriatric Pharmacology
• Drug Safety Evaluation
• Clinical Pharmacy

Background:

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are frequently prescribed for elderly individuals.
• NSAID use is associated with adverse effects, including gastrointestinal bleeding.
• Potentially Inappropriate Medications (PIM) criteria help identify risky drug prescriptions.

Purpose of the Study:

• To compare the detection rates of PIM by NSAIDs using the original Beers Criteria and its Spanish adaptation.
• To investigate the association between PIM of NSAIDs and gastrointestinal bleeding in elderly patients.

Main Methods:

• Retrospective observational study in a Spanish primary care district.
• Population: 7,856 individuals aged 65 and above prescribed at least one drug.
• Evaluation of PIM using original and Spanish adapted Beers Criteria; analysis of gastrointestinal bleeding events.

Main Results:

• The Spanish adaptation identified PIM of NSAIDs in 7.0% of patients, a 25.5% increase compared to the original 5.6% (p<0.001).
• PIM of NSAIDs showed a trend towards increased gastrointestinal bleeding (RR=1.6), but this was not statistically significant.
• No significant difference in gastrointestinal bleeding incidence was found between PIM-exposed and NSAID-exposed patients.

Conclusions:

• The Spanish adaptation of Beers Criteria is more sensitive in detecting PIM of NSAIDs in the elderly population.
• Neither the original nor the adapted Beers Criteria identified PIM of NSAIDs as significantly increasing gastrointestinal bleeding risk compared to general NSAID exposure.