title: Gastrointestinal risk assessment in patients requiring non-steroidal anti-inflammatory drugs for osteoarthritis: The GIRANO study.
abstract: OBJECTIVE
  To evaluate gastrointestinal risk profiles in patients with osteoarthritis who are currently being treated, or who are candidates for treatment, with a non-steroidal anti-inflammatory drug.
  
  
  METHODS
  Patients with osteoarthritis treated by primary care physicians or physical and rehabilitation medicine (PRM) specialists in Belgium and Luxembourg were scored for gastrointestinal risk profile, low, moderate or high, based on the presence of gastrointestinal risk factors. These included advanced age, gastrointestinal history, comorbidities, medication use, smoking, and alcohol consumption. Use of gastro-protective agents (proton pump inhibitors) was also assessed.
  
  
  RESULTS
  A total of 190 primary care physicians and PRM specialists provided data on 885 patients. A large majority of patients were rated high-risk gastrointestinal (77.8%), with fewer moderate (19.4%) or low (2.8%) risk. The proportion of high-risk patients treated by PRM specialists was significantly lower than that treated by primary care physicians (64.7% vs 79.9%; p < 0.0001). Only 37.0% of high-risk patients received proton pump inhibitors co-prescription with a non-steroidal anti-inflammatory drug.
  
  
  CONCLUSIONS
  A high prevalence of elevated gastrointestinal risk was found in this survey of patients with osteoarthritis who were current or candidate users of non-steroidal anti-inflammatory drugs. This appears to be insufficiently recognized, as preventative gastro-protective co-treatment was infrequently prescribed. Careful assessment of gastrointestinal risk factors should be made before prescribing non-steroidal anti-inflammatory drugs, with treatment tailored to the patient's gastrointestinal risk profile.
authors.affiliation: Department of Rehabilitation Sciences and Physical Therapy, Faculty of Medicine and Health Sciences, Ghent University Hospital, De Pintelaan 185, BE-9000 Ghent, Belgium. guy.vanderstraeten@ugent.be, guy.vanderstraeten@uzgent.be.
authors.forename: Guy
authors.initials: G
authors.lastname: Vanderstraeten
authors.forename: Thierry M
authors.initials: TM
authors.lastname: Lejeune
authors.forename: Hubert
authors.initials: H
authors.lastname: Piessevaux
authors.forename: Dirk
authors.initials: D
authors.lastname: De Bacquer
authors.forename: Chris
authors.initials: C
authors.lastname: Walker
authors.forename: Birgit
authors.initials: B
authors.lastname: De Beleyr
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001530:Belgium; D003430:Cross-Sectional Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology*; D006801:Humans; D008189:Luxembourg; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy*; D010810:Physical and Rehabilitation Medicine / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors