PMID- 19210152
OWN - NLM
STAT- MEDLINE
DCOM- 20090414
LR  - 20190911
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 25
IP  - 1
DP  - 2009 Jan
TI  - Gastroprotection among new chronic users of non-steroidal anti-inflammatory 
      drugs: a study of utilization and adherence in The Netherlands.
PG  - 195-204
LID - 10.1185/03007990802632915 [doi]
AB  - OBJECTIVE: To describe the use of gastroprotection (GP) among new chronic users 
      of NSAIDs in the Netherlands by gastrointestinal (GI) risk factor (RF) score. 
      METHODS: Data for this retrospective follow-up study were extracted from the 
      PHARMO database. We selected new chronic users of COX-2 inhibitors (coxibs) or 
      traditional NSAIDs (tNSAIDs) between 1st January 2000 and 31st December 2004. GP 
      strategies were defined as: use of proton pump inhibitors (PPI), coxibs or both. 
      GI RF score at index date was based on: history of GI drug use, high dose of 
      NSAIDs, age > 60 years, use of corticosteroids/anticoagulants/SSRIs, rheumatoid 
      arthritis, heart failure or diabetes, with each condition accounting for one 
      factor. Switching was assessed among those with > or = 1 GI RF during the first 
      year of follow-up. RESULTS: Among 58,770 new chronic NSAID users at index date, 
      80% used tNSAIDs alone, 8% used tNSAID + PPI, 10% used a coxib alone and 2% used 
      coxib + PPI. Mean (SD) number of GI RF among these groups was 1.6 (2.1), 3.1 
      (1.3), 1.5 (1.5) and 2.8 (1.3), respectively. Among 48 390 patients (82.3%) with 
      a GI RF score of > or = 1, 20.9% used a GP strategy, this increased with number 
      of GI RFs. Within the first year, 5.3% (n = 2067) and 4.8%(n = 1 843) of tNSAID 
      users with > or = 1 GI RF switched to tNSAID+PPI and coxib alone, respectively. 
      CONCLUSIONS: Gastroprotection in users of tNSAIDs was inadequate. Over 80% of 
      NSAID users with > or = 1 GI RF did not receive any gastroprotection, and even 
      when prescribed, a PPI is used only half the time. More research should show if 
      gastroprotection was used for prevention.
FAU - Van der Linden, Michiel W
AU  - Van der Linden MW
AD  - PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands.
FAU - Gaugris, Sabine
AU  - Gaugris S
FAU - Kuipers, Ernst J
AU  - Kuipers EJ
FAU - Van den Bemt, Bart J F
AU  - Van den Bemt BJ
FAU - van Herk-Sukel, Myrthe P P
AU  - van Herk-Sukel MP
FAU - Herings, Ron M C
AU  - Herings RM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Cyclooxygenase Inhibitors)
SB  - IM
MH  - Anti-Inflammatory Agents, Non-Steroidal/*adverse effects
MH  - Cohort Studies
MH  - Cyclooxygenase Inhibitors/*adverse effects
MH  - *Drug Utilization Review
MH  - Humans
MH  - Netherlands
MH  - *Patient Compliance
MH  - Retrospective Studies
MH  - Stomach Ulcer/*prevention & control
EDAT- 2009/02/13 09:00
MHDA- 2009/04/15 09:00
CRDT- 2009/02/13 09:00
PHST- 2009/02/13 09:00 [entrez]
PHST- 2009/02/13 09:00 [pubmed]
PHST- 2009/04/15 09:00 [medline]
AID - 10.1185/03007990802632915 [pii]
AID - 10.1185/03007990802632915 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2009 Jan;25(1):195-204. doi: 10.1185/03007990802632915.