Gastroprotection in NSAID and low-dose aspirin users: A cross-sectional study in primary care
Gastroprotection in NSAID and low-dose aspirin users: A cross-sectional study in primary care
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DOI：
10.1016/j.gastrohep.2011.10.004
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发表时间：
2012-01-01
影响因子：
1.9
通讯作者：
Munoz-Tuduri, Marta
中科院分区：
文献类型：
--
作者：
Lanas, Angel;Plazas, Ma Josep;Munoz-Tuduri, Marta
胃肠道（GI）并发症是与使用非甾体抗炎药（NSAID）和低剂量阿司匹林（LDA）相关的常见副作用。预防胃肠道并发症的指南确定高危患者应接受胃保护。然而，不同的报告表明，这些策略并没有得到很大的执行。为了确定西班牙初级保健中NSAID和/或LDA使用者使用预防策略以减少胃肠道并发症的流行程度，我们进行了一项观察性、横断面、多中心研究，西班牙初级保健医生参与了该研究。从2009年1月到2009年5月，医生收集了2008年最后一次就诊的前5名符合选择标准的患者的人口学、临床和治疗数据。进行了多变量逻辑回归，以确定所使用的预防策略的独立预测因子。共有713名初级保健医生包括3357名患者：68%的NSAID使用者，19.1%的LDA使用者和12.9%的NSAID/LDA使用者。31.5%的患者没有胃肠道并发症的危险因素，25.6%的患者有一个危险因素，42.9%的患者有两个或两个以上的危险因素。预防策略总体使用率为75.8%。随着危险因素的增加，胃保护的使用也在增加。在接受非甾体抗炎药治疗的高危患者中，胃保护的未充分利用的情况很低，而且不像以前在其他国家的初级保健水平报道的那样明显。我们还发现，在LDA使用者中，胃保护剂的使用率很高。(C) 2011 Elsevier Espana， S.L.版权所有
Gastrointestinal (GI) complications are common side effects related to non-steroidal anti-inflammatory drugs (NSAID) and low-dose aspirin (LDA) use. The guidelines to prevent GI complications establish that patients at high risk should receive gastroprotection. However, different reports have suggested that these strategies are not greatly executed. To determine the prevalence of use of preventive strategies to reduce GI complications in NSAID and/or LDA users in primary care in Spain, we performed an observational, cross-sectional, multi-centre study in which primary care physicians from Spain participated. From January 2009 to May 2009, physicians collected demographic, clinical and treatment data from the last visit in 2008 of the first 5 consecutive patients who met the selection criteria. A multivariate logistic regression was carried out to identify independent predictors of the preventive strategies used.A total of 713 primary care physicians included 3357 patients: 68% NSAID users, 19.1% LDA users and 12.9% NSAID/LDA users. 31.5% of patients did not have a risk factor for GI complications, 25.6% had one risk factor and 42.9% had 2 or more risk factors. The overall prevalence of preventive strategy use was 75.8%. The prevalence of gastroprotection use increased with the number of risk factors.The underutilization of gastroprotection in at-risk patients treated with NSAIDs is low and not as marked as those previously reported at the primary care level in other countries. We also found high rates of gastroprotection use in LDA users. (C) 2011 Elsevier Espana, S.L. All rights reserved.