PMID- 22298501
OWN - NLM
STAT- MEDLINE
DCOM- 20120815
LR  - 20181201
IS  - 1099-1557 (Electronic)
IS  - 1053-8569 (Linking)
VI  - 21
IP  - 5
DP  - 2012 May
TI  - Predictors and time trends in clopidogrel and proton pump inhibitor 
      coprescription with low-dose acetylsalicylic acid.
PG  - 463-9
LID - 10.1002/pds.3195 [doi]
AB  - PURPOSE: To determine trends and predictors of clopidogrel and proton pump 
      inhibitor (PPI) coprescription with low-dose acetylsalicylic acid (ASA) 
      prescribed for secondary cardiovascular or cerebrovascular disease (CVD) 
      prevention in UK primary care. METHODS: Patients aged 50-84 years who received a 
      first prescription for low-dose ASA for secondary CVD prevention in 2000-2001 (n 
      = 10,330) or 2006-2007 (n = 8154) were identified in The Health Improvement 
      Network UK primary care database. Clopidogrel or PPI coprescriptions received 
      within 15 days after the first low-dose ASA prescription were ascertained. 
      RESULTS: Clopidogrel coprescription with low-dose ASA increased from 1.6% to 
      25.2% between the two study periods; PPI coprescription increased from 11.6% to 
      28.3%. Low-dose ASA indications of myocardial infarction [odds ratio (OR) 11.7, 
      95% confidence interval (CI) 10.2 to 13.4] and unstable angina (OR 1.73, 95%CI 
      1.09 to 2.75) were positive predictors of clopidogrel coprescription in 
      2006-2007, relative to chronic ischaemic heart disease. Patients at high risk of 
      upper gastrointestinal bleeding were more likely to receive a PPI than those at 
      lower risk in 2006-2007 (OR 4.36, 95%CI 3.93 to 4.84). In this period, 65.5% of 
      patients who required a clopidogrel coprescription according to guideline 
      recommendations received one, and 44.3% of patients at high risk of upper 
      gastrointestinal bleeding received a PPI. CONCLUSION: Clopidogrel and PPI 
      coprescription with low-dose ASA increased markedly between 2000-2001 and 
      2006-2007; however, many patients on low-dose ASA did not receive the recommended 
      coprescriptions at the end of the study period.
CI  - Copyright (c) 2012 John Wiley & Sons, Ltd.
FAU - Cea Soriano, Lucia
AU  - Cea Soriano L
AD  - Spanish Centre for Pharmacoepidemiologic Research (CEIFE), Madrid, Spain. 
      luciaceife@telefonica.net
FAU - Bueno, Hector
AU  - Bueno H
FAU - Johansson, Saga
AU  - Johansson S
FAU - Garcia Rodriguez, Luis A
AU  - Garcia Rodriguez LA
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120201
PL  - England
TA  - Pharmacoepidemiol Drug Saf
JT  - Pharmacoepidemiology and drug safety
JID - 9208369
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
RN  - OM90ZUW7M1 (Ticlopidine)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aspirin/administration & dosage/adverse effects/*therapeutic use
MH  - Cardiovascular Diseases/prevention & control
MH  - Cerebrovascular Disorders/prevention & control
MH  - Clopidogrel
MH  - Drug Therapy, Combination
MH  - Female
MH  - Gastrointestinal Hemorrhage/chemically induced/prevention & control
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/administration & dosage/adverse 
      effects/*therapeutic use
MH  - Practice Guidelines as Topic
MH  - Practice Patterns, Physicians'/standards/statistics & numerical data
MH  - Primary Health Care/statistics & numerical data
MH  - Proton Pump Inhibitors/administration & dosage/*therapeutic use
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Ticlopidine/administration & dosage/adverse effects/*analogs & 
      derivatives/therapeutic use
MH  - Time Factors
MH  - United Kingdom
EDAT- 2012/02/03 06:00
MHDA- 2012/08/16 06:00
CRDT- 2012/02/03 06:00
PHST- 2011/07/04 00:00 [received]
PHST- 2011/11/14 00:00 [revised]
PHST- 2011/11/28 00:00 [accepted]
PHST- 2012/02/03 06:00 [entrez]
PHST- 2012/02/03 06:00 [pubmed]
PHST- 2012/08/16 06:00 [medline]
AID - 10.1002/pds.3195 [doi]
PST - ppublish
SO  - Pharmacoepidemiol Drug Saf. 2012 May;21(5):463-9. doi: 10.1002/pds.3195. Epub 
      2012 Feb 1.