Are the clinical guideline recommendations on gastroprotection being followed? A review in patients taking nonsteroidal anti-inflammatory drugs.
OBJECTIVE
The chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs) can cause complications in the gastrointestinal tract. The use of proton pump inhibitors (PPIs) is recommended in high-risk patients to prevent them.


OBJECTIVE
The aim of this article was to evaluate the gastroprotection measures taken in persons with chronic NSAID use.


METHODS
A descriptive cross-sectional study was conducted. The clinical records were reviewed of patients seen as outpatients at the Rheumatology Department over a 4-month period, choosing those with chronic NSAID use, and intentionally looking for gastroprotection measures according to the recommendations published by the American College of Gastroenterology.


RESULTS
A total of 417 patients (347 women; mean age: 48.12±14.2 years) were included. The most frequent diagnosis was rheumatoid arthritis (65%). Nine patients (2.1%) had a history of peptic ulcer, 48 (11.5%) patients were 65 years of age or older, 26 (6.2%) patients took NSAIDs and aspirin, and 130 (31.2%) took NSAIDs with steroids. Tests for Helicobacter pylori infection were done in just 53 cases, and there were positive results in only 9 (16%). Some risk for gastrointestinal toxicity was established in 211 cases and only 65 (30.8%) received gastroprotection. In contrast, 31 (15%) patients received gastroprotection when there was no indication for it.


CONCLUSIONS
Prophylaxis with PPIs in chronic NSAID users was inadequately employed. It was not prescribed in the majority of patients (69.2%) and it was used with no justification in others (15%).
Residente de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Ciudad de México, México.
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Velasco-Zamora
Adscrita al Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Ciudad de México, México.
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Gómez-Reyes
Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Ciudad de México, México. Electronic address: luis.uscangad@gmail.com.
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Uscanga
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D013272:Stomach Diseases / Q000139:chemically induced* / Q000517:prevention & control*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors
Adverse effect; Antiinflamatorios no esteroideos; Efecto adverso; Gastrointestinal risk; Gastroprotección; Gastroprotection; Inhibidor de la bomba de protones; Nonsteroidal anti-inflammatory drugs; Proton pump inhibitors; Riesgo gastrointestinal