[Analysis of differences between indication and prescription of gastroprotection in patients with risk factors treated with nonsteroidal anti-inflammatory agents: the GAP study].
Preventive measures in patients treated with nonsteroidal anti-inflammatory drugs (NSAIDS) have been reported to be underused. The aim of the present study was to analyze differences between the indication and prescription of gastroprotection with proton pump inhibitors (PPI) in patients treated with NSAIDS and with risk factors for gastrointestinal complications.


METHODS
We performed an observational, cross-sectional, multicenter study. Data were gathered retrospectively from medical records and from a questionnaire on risk factors and indication for gastroprotection.


RESULTS
A total of 432 physicians gathered data from 2,160 patients treated with NSAIDs. Nearly all (90.4%) of the patients were prescribed gastroprotection with a PPI. Long-term versus short-term (<1 month) NSAID treatment was associated with gastroprotection (OR=2.37; 95% CI 1.779-3.171). The mean number of risk factors per patient was 2+/-0.16 (range 0-7), and a significant association was found between the number of risk factors and the percentage of patients receiving gastroprotection. Nevertheless, the proportion of patients with risk factors not receiving gastroprotection was 3% for those with a prior history of ulcer and/or gastrointestinal bleeding due to NSAIDS and 7-10% for the remaining factors. Differences were found between the indication for gastroprotection and the gastroprotection prescribed among the various specialties. The specialists prescribing gastroprotection the least were radiotherapy specialists.


CONCLUSIONS
These results demonstrate that, in daily clinical practice, differences between the indication and prescription of gastroprotection in patients treated with NSAIDS and with risk factors are small in Spain.
Lanas
Angel
A
Servicio de Aparato Digestivo, Hospital Clínico Lozano Blesa, CIBERehd, Instituto Aragonés de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España. angel.lanas@gmail.com
Muñoz
Maria
M
Caballero Correa
Maria
M
Martínez Jiménez
Pedro
P
D000367:Age Factors; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D005767:Gastrointestinal Diseases / Q000517:prevention & control*; D006801:Humans; D008511:Medicine; D008875:Middle Aged; D016595:Misoprostol / Q000008:administration & dosage / Q000627:therapeutic use; D010166:Palliative Care; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain; D011795:Surveys and Questionnaires
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors; D016595:Misoprostol