A guideline for the treatment and prevention of nsaid-induced ulcers

Lanza, Frank L.

doi:10.1016/s0002-9270(98)00469-9

Cited by 93 publications

(77 citation statements)

References 111 publications

(110 reference statements)

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“…Aspirin and NSAIDs had been reported as a cause of peptic ulcer disease and UGI bleeding in 5 cases (13.51%). This coincides with Lanza 14 who proved an increased risk of GI complication with the use of NSAIDs by 5.57 in patients above the age of 50 years. Upper GI bleeding is more common in the age group between 36-55 years 31 patients (48.4%), they bled mostly due to peptic ulcer disease and rupture esophageal varices.…”

Section: Discussionsupporting

confidence: 89%

One Year Experience with Upper Gastrointestinal Bleeding at King Khaled Civilian Hospital (K.K.C.H) –Tabuk- K.S.A

2008

Al-Azhar University Journal of Virus Researches and Studies

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Section: Discussionsupporting

confidence: 89%

One Year Experience with Upper Gastrointestinal Bleeding at King Khaled Civilian Hospital (K.K.C.H) –Tabuk- K.S.A

2008

Al-Azhar University Journal of Virus Researches and Studies

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“…GI complications, assessed from International Classifi cation of Diseases, Ninth Revision (ICD-9) codes, included a history of peptic ulcer (codes 531.xx-534.xx), gastritis and duodenitis (code 535.xx), or gastrointestinal hemorrhage (code 578.xx). The risk factor defi nitions were based on guidelines from the American College of Gastroenterology 20 with some modifi cations. For example, although these…”

Section: Setting and Populationmentioning

confidence: 99%

“…guidelines defi ne an age of older than 60 years as a risk factor 20 and most guidelines use this age or an age of 65 years or older, 2 we chose an age of 75 years or older because a recent publication suggested that this is the age at which risk rises dramatically. 21 There was no consent for individual study patients, because data were deidentifi ed and patients were receiving usual care as deemed appropriate by their clinician.…”

Section: Ehr Decision Supp or T F Or Pat Ien T S On Ns A Idsmentioning

confidence: 99%

Impact of EHR-Based Clinical Decision Support on Adherence to Guidelines for Patients on NSAIDs: A Randomized Controlled Trial

Gill

Mainous

Koopman

et al. 2011

The Annals of Family Medicine

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PURPOSE Electronic health records (EHRs) with clinical decision support hold promise for improving quality of care, but their impact on management of chronic conditions has been mixed. This study examined the impact of EHR-based clinical decision support on adherence to guidelines for reducing gastrointestinal complications in primary care patients on nonsteroidal anti-infl ammatory drugs (NSAIDs). METHODSThis randomized controlled trial was conducted in a national network of primary care offi ces using an EHR and focused on patients taking traditional NSAIDs who had factors associated with a high risk for gastrointestinal complications (a history of peptic ulcer disease; concomitant use of anticoagulants, antiplatelet medications [including aspirin], or corticosteroids; or an age of 75 years or older). The offi ces were randomized to receive EHR-based guidelines and alerts for high-risk patients on NSAIDs, or usual care. The primary outcome was the proportion of patients who received guideline-concordant care during the 1-year study period (June 2007-June 2008), defi ned as having their traditional NSAID discontinued (including a switch to a lower-risk medication), having a gastroprotective medication coprescribed, or both. RESULTSParticipants included 27 offi ces with 119 clinicians and 5,234 highrisk patients. Intervention patients were more likely than usual care patients to receive guideline-concordant care (25.4% vs 22.4%, adjusted odds ratio = 1.19; 95% confi dence interval, 1.01-1.42). For individual high-risk groups, patients on low-dose aspirin were more likely to receive guideline-concordant care with the intervention vs usual care (25.0% vs 20.8%, adjusted odds ratio = 1.30; 95% confi dence interval, 1.04-1.62), but there was no signifi cant difference for patients in other high-risk groups.CONCLUSIONS This study showed only a small impact of EHR-based clinical decision support for high-risk patients on NSAIDs in primary care offi ces. These results add to the growing literature about the complexity of EHR-based clinical decision support for improving quality of care.

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“…They are mainly prescribed for treatment of arthritis and pain (1). The main concern with NSAIDs is their gastrointestinal (GI) safety (2)(3)(4)(5)(6)(7)(8)(9). NSAIDs can induce perforation, ulcer, and bleed (PUB) that may be fatal in some patients (4,10).…”

Section: Introductionmentioning

confidence: 99%

Use of NSAIDs, COX‐2 inhibitors, and acetaminophen and associated coprescriptions of gastroprotective agents in an elderly population

Rahme

Marentette

Kong

et al. 2002

Arthritis & Rheumatism

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A guideline for the treatment and prevention of nsaid-induced ulcers

Cited by 93 publications

References 111 publications

One Year Experience with Upper Gastrointestinal Bleeding at King Khaled Civilian Hospital (K.K.C.H) –Tabuk- K.S.A

One Year Experience with Upper Gastrointestinal Bleeding at King Khaled Civilian Hospital (K.K.C.H) –Tabuk- K.S.A

Impact of EHR-Based Clinical Decision Support on Adherence to Guidelines for Patients on NSAIDs: A Randomized Controlled Trial

Use of NSAIDs, COX‐2 inhibitors, and acetaminophen and associated coprescriptions of gastroprotective agents in an elderly population

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