Primary care physician perceptions of non-steroidal anti-inflammatory drug and aspirin-associated toxicity: results of a national survey.
OBJECTIVE
To assess primary care physician perceptions of non-steroidal anti-inflammatory drug (NSAID) and aspirin-associated toxicity.


METHODS
A group of gastroenterologists and internal medicine physicians created a survey, which was administered via the Internet to a large number of primary care physicians from across the US.


RESULTS
One thousand primary care physicians participated. Almost one-third of primary care physicians recommended 325 mg rather than 81 mg of aspirin/day for cardioprotection. Fifty-nine percent thought enteric-coated or buffered aspirin reduced the risk of upper gastrointestinal (GI) bleeding. Seventy-six percent believed that Helicobacter pylori infection increased the risk of NSAID ulcers but fewer than 25% tested NSAID users for this infection. More than two-thirds were aware that aspirin co-therapy decreased the GI safety benefits of the cyclo-oxygenase 2 selective NSAIDs. However, 84% felt that aspirin with a cyclo-oxygenase 2 selective NSAID was safer than aspirin with a non-selective NSAID. When presented a patient at high risk for NSAID-related GI toxicity, almost 50% of primary care physicians recommended a proton pump inhibitor and cyclo-oxygenase 2 selective NSAID.


CONCLUSIONS
This survey has identified areas of misinformation regarding the risk-benefit of NSAIDs and aspirin and the utilization of gastroprotective strategies. Further education on NSAIDs for primary care physicians is warranted.
Chey
W D
WD
Division of Gastroenterology, University of Michigan, Ann Arbor, MI, USA. wchey@umich.edu
Eswaren
S
S
Howden
C W
CW
Inadomi
J M
JM
Fendrick
A M
AM
Scheiman
J M
JM
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001241:Aspirin / Q000009:adverse effects* / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002316:Cardiotonic Agents / Q000009:adverse effects / Q000627:therapeutic use; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications; D019538:Health Care Surveys; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000139:chemically induced / Q000150:complications; D010821:Physicians, Family / Q000523:psychology; D011320:Primary Health Care; D054328:Proton Pump Inhibitors; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D002316:Cardiotonic Agents; D052246:Cyclooxygenase 2 Inhibitors; D054328:Proton Pump Inhibitors; D001241:Aspirin