PMID- 19845420
OWN - NLM
STAT- MEDLINE
DCOM- 20100113
LR  - 20091022
IS  - 1936-2692 (Electronic)
IS  - 1088-0224 (Linking)
VI  - 15
IP  - 10
DP  - 2009 Oct
TI  - Impact of compliance with proton pump inhibitors on NSAID treatment.
PG  - 681-8
AB  - OBJECTIVE: To assess the impact of patient compliance with proton pump inhibitor 
      (PPI) therapy on nonsteroidal anti-inflammatory drug (NSAID) treatment duration 
      and upper-gastrointestinal (GI) complications in patients with gastroesophageal 
      reflux disease (GERD). STUDY DESIGN: Retrospective cohort study. METHODS: Study 
      subjects were GERD patients receiving cotherapy with a PPI and a 
      cyclooxygenase-2-selective (COX-2-selective) or nonselective NSAID. Patients 
      compliant and noncompliant with PPI therapy were compared on NSAID treatment 
      duration and incidence of upper-GI events. Kaplan-Meier analysis and a 
      multivariate Cox proportional hazards model were used to compare durations of 
      NSAID treatment, controlling for baseline characteristics. The incidences of GI 
      events were compared using incidence rate and Poisson regression models. The 
      analyses were conducted separately for patients taking COX-2-selective NSAIDs and 
      those taking nonselective NSAIDs. RESULTS: In both patient groups taking a 
      COX-2-selective agent (n = 12,562; 70.9% compliant) and nonselective NSAID (n = 
      17,487; 69.9% compliant), mean NSAID treatment duration was significantly longer 
      (84.0 days and 20.8 days longer, respectively) in PPI-compliant patients than in 
      noncompliant patients. Compliance with PPI therapy was associated with a greater 
      reduction in the incidence of GI events than noncompliance in both patients 
      taking a COX-2-selective NSAID (6-fold vs 5-fold; P = .026) and patients taking a 
      nonselective NSAID (8-fold vs 6-fold; P = .002). CONCLUSIONS: In GERD patients 
      receiving NSAIDs, those who were compliant with PPI therapy had a longer NSAID 
      treatment duration and better GI tolerability than those who were noncompliant.
FAU - Duh, Mei Sheng
AU  - Duh MS
AD  - Analysis Group, Inc, Boston, MA 02199, USA. mduh@analysisgroup.com
FAU - Gosselin, Antoine
AU  - Gosselin A
FAU - Luo, Roger
AU  - Luo R
FAU - Lohoues, Herve
AU  - Lohoues H
FAU - Lewis, Barbara E
AU  - Lewis BE
FAU - Crawley, Joseph A
AU  - Crawley JA
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Manag Care
JT  - The American journal of managed care
JID - 9613960
RN  - 0 (Cyclooxygenase 2 Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
MH  - Adult
MH  - Cyclooxygenase 2 Inhibitors/*adverse effects/therapeutic use
MH  - Drug Therapy, Combination
MH  - Female
MH  - Gastroesophageal Reflux/drug therapy
MH  - Gastrointestinal Diseases/chemically induced
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Patient Compliance
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Retrospective Studies
MH  - Upper Gastrointestinal Tract/drug effects
EDAT- 2009/10/23 06:00
MHDA- 2010/01/14 06:00
CRDT- 2009/10/23 06:00
PHST- 2009/10/23 06:00 [entrez]
PHST- 2009/10/23 06:00 [pubmed]
PHST- 2010/01/14 06:00 [medline]
AID - 11997 [pii]
PST - ppublish
SO  - Am J Manag Care. 2009 Oct;15(10):681-8.