Underuse of proton-pump inhibitors in older patients newly starting NSAID treatment.
Int J Clin Pract. 2015 Feb 4;
Authors: Hoffmann F, Glaeske G, Schmiemann G
OBJECTIVE: Proton pump inhibitors (PPIs) are recommended for the prevention of traditional non-steroidal anti-inflammatory drugs (tNSAIDs)-related ulcer complications in high-risk patients. We aimed to study to which extent older persons initiating tNSAIDs with and without oral corticosteroids receive PPIs and whether sex and age influence treatment.
METHODS: We analysed claims data of the German health insurance company BARMER GEK, covering about 9 million persons. A cohort of new users of tNSAIDs aged 65 years and older starting treatment from 1 January 2011, through 1 December 2012 was included. Concurrent use of oral corticosteroids was assessed within the 28 days before the index date. Persons were categorised as users of PPIs if they filled a prescription within 28 days before or after the index prescription.
RESULTS: A total of 83,326 persons met the inclusion criteria (64.1% females; mean age: 74.7 years). Of these new users of tNSAID, 27.8% received PPIs within 28 days before or after the index date (females: 29.4% and males: 25.0%). Of the 2857 persons with concurrent prescriptions of oral corticosteroids, 42.8% also received PPIs (females: 43.4% and males: 41.8%). An increase in prescribing of PPIs with age was found in all new users as well as in those concurrently receiving oral corticosteroids.
CONCLUSIONS: We found that gastroprotective agents are not prescribed to older new users of tNSAIDs as recommended. When compared with earlier studies, adherence to guidelines still remains low.
PMID: 25652848 [PubMed - as supplied by publisher]