Sociodemographic factors influence use of proton pump inhibitors among users of nonsteroidal anti-inflammatory drugs.
OBJECTIVE
Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most frequently prescribed drugs. Although adequate gastroprotection is indicated in individuals at high risk for upper gastrointestinal complications, underutilization of preventive strategies has been demonstrated. We investigated the utilization of proton pump inhibitors (PPIs) in high risk, short term users of NSAIDs and assessed the association between sociodemographic factors and the rates at which PPIs are prescribed.


METHODS
A retrospective study was conducted using data from 2.8 million individuals. Short term use was defined as an isolated period of NSAID use between 7 to 30 days. Logistic regression was performed to determine sociodemographic factors associated with PPI inhibitor use.


RESULTS
A total of 155,825 short term users of NSAID were identified. Of these, 52,842 subjects (33.9%) had 1 or more risk factors; 56.1% of these subjects did not receive PPIs. Utilization was associated with sociodemographic factors of patients (such as older age [odds ratio (OR), 1.80; 95% confidence interval (CI), 1.64-1.99], female gender [OR, 1.14; 95% CI, 1.10-1.18], risk factors for upper gastrointestinal complications [OR, 3.72; 95% CI, 3.45-4.00]) and physicians (such as female gender [OR, 1.09; 95% CI, 1.03-1.14], practice in a deprived area [OR, 0.57; 95% CI, 0.53-0.61], or an urban area [OR, 0.86; 95% CI, 0.82-0.90]).


CONCLUSIONS
Adequate gastroprotection is not provided to more than 50% of short term users of NSAIDs who are at an increased risk for upper gastrointestinal complications. Utilization is associated with sociodemographic factors of patients and physicians.
van Boxel
Ofke S
OS
Dept of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht.
Hagenaars
Matthijs P
MP
Smout
André J P M
AJ
Siersema
Peter D
PD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003710:Demography; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors