The effect of nonsteroidal anti-inflammatory drugs on the use of gastroprotective medication in people with arthritis.
OBJECTIVE
To estimate the incidence of gastroprotective medication use among users and nonusers of prescription nonsteroidal anti-inflammatory drugs (NSAIDs) who have arthritis.


METHODS
A retrospective cohort study.


METHODS
We used the Protocare Sciences proprietary Managed Care Organization database, which contains data on more than 3 million lives, to identify 57,136 patients given an initial diagnosis of osteoarthritis (OA; International Classification of Disease, Ninth Revision, Clinical Modification [ICD-9-CM] codes: 715, 721.0, 721.3, or 721.9) or rheumatoid arthritis (RA; ICD-9-CM codes: 714.0, 714.1, 714.2, or 714.9); the diagnoses were made during inpatient or outpatient medical encounters occurring between October 1, 1993, and September 30, 1997. The duration of therapy was calculated as the sum of the total number of days of receipt of all prescriptions during the year. The prescribed daily dose was determined by multiplying the drug dose by the number of pills dispensed and the dividing the product by the number of days supplied, as noted in the pharmacy records.


RESULTS
During the year after NSAID initiation, 27% of people with RA and 12% of those with OA were chronic NSAID users. NSAID users with RA were 4 times as likely as NSAID nonusers with RA to begin using a gastroprotective agent within the first year; NSAID users with OA were twice as likely as nonusers with OA to do so.


CONCLUSIONS
The use of gastroprotective agents during the first year after NSAID initiation for the treatment of arthritis was greater than their use by those who did not take NSAIDs.
Lapane
K L
KL
Center for Gerontology and Health Care Research, Brown University, Box G-B222, 171 Meeting Street, Providence, RI 02912. kate_lapane@brown.edu
Spooner
J J
JJ
Pettitt
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001168:Arthritis / Q000188:drug therapy*; D015331:Cohort Studies; D004064:Digestive System / Q000187:drug effects*; D017723:Drug Utilization Review; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005765:Gastrointestinal Agents