PMID- 21489310
OWN - NLM
STAT- MEDLINE
DCOM- 20110907
LR  - 20211020
IS  - 1741-7015 (Electronic)
IS  - 1741-7015 (Linking)
VI  - 9
DP  - 2011 Apr 14
TI  - Prescription patterns and appropriateness of NSAID therapy according to 
      gastrointestinal risk and cardiovascular history in patients with diagnoses of 
      osteoarthritis.
PG  - 38
LID - 10.1186/1741-7015-9-38 [doi]
AB  - BACKGROUND: Prescription of non-steroidal anti-inflammatory drugs (NSAIDs) should 
      be based on the assessment of both gastrointestinal (GI) and cardiovascular (CV) 
      risk for the individual patient. We aimed to assess the GI/CV risk profile and 
      the pharmacological management of patients with osteoarthritis (OA) in clinical 
      practice. METHODS: We conducted a cross-sectional, multicentre, observational 
      study of consecutive OA patients that visited 1,760 doctors throughout the 
      Spanish National Health System (NHS) in a single day. The presence of GI risk 
      factors, CV histories, hypertension and current pharmacological treatments was 
      recorded. RESULTS: Of the 60,868 patients, 17,105 had a diagnosis of OA and were 
      evaluable. The majority (93.4%) had more than one GI risk factor and 60.3% were 
      defined to be at high-GI risk. Thirty-two percent had a history of CV events, 
      57.6% were treated with anti-hypertensive therapy and 22.6% had uncontrolled 
      hypertension. One-fifth of patients were treated with non-NSAID therapies, 
      whereas the remaining patients received NSAIDs. Non-selective NSAIDs (nsNSAID) 
      plus proton pump inhibitor (PPI) or cyclooxigenase-2 (COX-2)-selective NSAIDs 
      alone were more frequently prescribed in patients at increased GI risk. Patients 
      with a positive CV history received nsNSAIDs or COX-2-selective NSAIDs in 41.3% 
      and 31.7% of cases, respectively. When both the GI and CV histories were 
      combined, 51% of the overall population was being prescribed drugs that were 
      either not recommended or contraindicated. CONCLUSIONS: Over 90% of patients with 
      OA are at increased GI and/or CV risk. In over half of these patients, the 
      prescription of NSAIDs was not in accordance with current guidelines or 
      recommendations made by regulatory agencies.
FAU - Lanas, Angel
AU  - Lanas A
AD  - University of Zaragoza Medical School, Aragon Health Research Institute, 
      CIBERehd, Zaragoza, Spain. angel.lanas@gmail.com
FAU - Garcia-Tell, Guillermo
AU  - Garcia-Tell G
FAU - Armada, Beatriz
AU  - Armada B
FAU - Oteo-Alvaro, Angel
AU  - Oteo-Alvaro A
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20110414
PL  - England
TA  - BMC Med
JT  - BMC medicine
JID - 101190723
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage/adverse effects
MH  - Cardiovascular Diseases/chemically induced/complications/*epidemiology
MH  - Cross-Sectional Studies
MH  - Drug Utilization/*statistics & numerical data
MH  - Female
MH  - Gastrointestinal Diseases/chemically induced/complications/*epidemiology
MH  - Guideline Adherence/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Osteoarthritis/complications/*drug therapy
MH  - Prescriptions/*statistics & numerical data
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Spain
PMC - PMC3101123
EDAT- 2011/04/15 06:00
MHDA- 2011/09/08 06:00
PMCR- 2011/04/14
CRDT- 2011/04/15 06:00
PHST- 2011/01/08 00:00 [received]
PHST- 2011/04/14 00:00 [accepted]
PHST- 2011/04/15 06:00 [entrez]
PHST- 2011/04/15 06:00 [pubmed]
PHST- 2011/09/08 06:00 [medline]
PHST- 2011/04/14 00:00 [pmc-release]
AID - 1741-7015-9-38 [pii]
AID - 10.1186/1741-7015-9-38 [doi]
PST - epublish
SO  - BMC Med. 2011 Apr 14;9:38. doi: 10.1186/1741-7015-9-38.