Non-steroidal anti-inflammatory drugs and gastroprotection gap among Family Physicians: Results from a survey

• Autor(a) principal: Areia,Miguel
• Data de Publicação: 2013
• Outros Autores: Pereira,António Dias, Banhudo,António, Coutinho,Graça
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-81782013000600003
• topic: Nonsteroidal/adverse effects; Aspirin/adverse effects; Peptic ulcer/prevention & control; Risk factors; Primary health care

Introduction: Use of non-steroidal anti-inflammatory drugs (NSAIDs) has increased over the last few years and identification of gastrointestinal risk factors is a key factor for prevention of its complications. Even after correct identification of those risk factors, only a small percentage of Family Physicians prescribe gastroprotection. Aims: To knowledge gastrointestinal risk factors and gastroprotection’s prescription by Family Physicians in patients receiving NSAIDs. Methods: Observational, cross-sectional, random sample study, using a survey among 300 Family Physicians, performed in 2007. Questions were asked about perceived patients rates or hypothetical scenarios and answers were valued on an intention-to-treat basis. The main outcome measure was the gastroprotection’s prescription rate among patients taking NSAIDs. Results: The perceived proportion of patients receiving NSAIDs was 38% and from these, 40% were taking gastroprotective drugs. The main identified gastrointestinal risk factors were: complicated peptic ulcer (98%), age ≥ 65 years (96%), smoking habits and alcohol consumption (96%), dyspepsia (95%), high-doses of NSAIDs (94%), corticosteroids co-administration (91%) and consumption of two or more NSAIDs (90%). Gastroprotection would be prescribed in 82% of patients with history of complicated peptic ulcer; 60% if receiving two or more or a high dose of NSAIDs; 53% if with Helicobacter pylori infection and 51% if aged ≥ 65 years. For all risk factors, gastroprotection use would be only of 47.3% (95% confidence interval: 45.6-49.0%). Conclusions: Family Physicians are aware of NSAIDs’ gastrointestinal toxicity but risk estimation seems inadequate since they will not prescribe gastrointestinal protection in more than half the cases.