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Gastric protection in cardiological practice: an Italian survey on the prescriptive attitude
Salvatore E Aragona1, Alberto Margonato2, Salvatore Felis3
1Unit of Surgery, ASST Melegnano Martesana, Melzo Hospital, Melzo, Milan, Italy.
Insights
Italian cardiologists prioritize gastric protection for patients on medications that harm the stomach. A survey revealed that this experience improved prescribing practices, especially regarding proton pump inhibitors (PPIs).
Area of Science:
- Gastroenterology
- Cardiology
- Clinical Pharmacy
Background:
- Gastric protection is crucial for patients using NSAIDs, antiplatelets, and anticoagulants.
- Cardiologists frequently prescribe gastroprotective agents to mitigate medication-induced gastric damage.
Purpose of the Study:
- To investigate the attitudes and practices of Italian cardiologists regarding gastric protection in clinical settings.
- To assess the impact of a survey experience on prescribing habits for gastroprotective agents.
Main Methods:
- A self-administered questionnaire was used to gather data from cardiologists over three months.
- Ninety Italian cardiologists participated in the survey.
Main Results:
- All cardiologists considered gastric protection, with proton pump inhibitors (PPIs) prescribed to 60% of patients.
- The survey experience led to a reassessment of PPI appropriateness, with discontinuation of inappropriate prescriptions.
- A novel triple-action medical device influenced a shift towards more appropriate gastroprotection strategies.
Conclusions:
- Appropriate prescription of gastric protectors is clinically significant.
- Longitudinal survey experience improved prescribing practices for PPIs and encouraged the use of new multi-action gastroprotective devices.
Background:
Gastric protection is commonly considered in patients who use medications able to damage gastric mucosa, mainly NSAIDs, antiplatelets, and anticoagulants. Therefore, cardiologists may frequently prescribe drugs to protect the stomach from damaging medications. The present survey investigated the attitude toward using gastric protection by a panel of Italian cardiologists.
Methods:
A self-administered questionnaire included three sections concerning practical problems on this issue in clinical practice facing patients with cardiological disorders. The questionnaire was administered in three successive months.
Results:
Ninety Italian cardiologists completed the questionnaire. They all consider gastric protection, mainly when prescribing potentially noxious medications. Usually, cardiologists prescribe proton pump inhibitors (PPIs) in 60% of their patients. Alginates and mucosal protectors are less considered. As a rule, cardiologists request investigations if the initial treatment fails. Moreover, the safety issue is carefully assessed. Furthermore, this survey experience significantly affected the approach to managing patients who require gastric protection. The participants carefully considered the prescriptive appropriateness of gastric protectors, mainly concerning the PPIs use. Consequently, PPIs were discontinued when inappropriate. A new medical device with triple action (antacid, mucosal protectors, and anti-reflux) contributed to this new attitude.
Conclusions:
The present survey underscored that the appropriateness in prescribing gastric protectors is clinically relevant. In addition, a longitudinal survey experience contributed to change the practical approach by highlighting the prescriptive appropriateness of PPIs, and using a new medical device with multiple gastroprotective activities.
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