title: Trends and determinants of adequate gastroprotection in patients chronically using NSAIDs.
abstract: OBJECTIVE
  To identify determinants and trends of gastroprotection in patients chronically using NSAIDs.
  
  
  METHODS
  
  
  
  METHODS
  retrospective cohort study.
  
  
  METHODS
  Agis Health Database (AHD) containing annual prescription records of approximately 1.5 million patients.
  
  
  METHODS
  All patients using more than 180 daily defined doses (DDD) annually, of any NSAID from 2001 to 2007.
  
  
  METHODS
  prevalence of NSAID use, adequate prescription of gastroprotective drugs (PPI, misoprostol or COX-2 inhibitor use), determinants of adequate gastroprotection.
  
  
  RESULTS
  The percentage of patients chronically using NSAIDs rose from 7.3% of the total NSAIDs users in 2001 to 7.5% in 2007. The percentage of patients on NSAIDs receiving adequate gastroprotective medication in line with actual guidelines increased from 39.6% in 2001 to 69.9% in 2007. Age over 70, co-prescription of SSRI, coumarine and steroids and arthritis are the main clinical factors predicting adequate prescription.
  
  
  CONCLUSIONS
  The prevalence of NSAID prescription and the risk of gastric complications is increasing steadily. Although the number of patients receiving gastroprotective medication is also increasing, over 30% of the patients at risk for GI complications were left unprotected in 2007. In order to improve protection rates in patients using NSAIDs and to decrease NSAID related hospital admissions in the future, the implementation of gastroprotection guidelines needs to be improved.
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg, 3584 CG Utrecht, The Netherlands. c.helsper@gmail.com
authors: Charles W
authors: CW
authors: Helsper
authors: Hugo M
authors: HM
authors: Smeets
authors: Mattijs E
authors: ME
authors: Numans
authors: Mirjam J
authors: MJ
authors: Knol
authors: Arno W
authors: AW
authors: Hoes
authors: Niek J
authors: NJ
authors: de Wit
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D019992:Databases as Topic; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D012189:Retrospective Studies; D012307:Risk Factors; D013276:Stomach Ulcer / Q000188:drug therapy* / Q000517:prevention & control*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents