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    Co-prescription of gastro-protectants in hospitalized patients: an analysis of what we do and what we think we do.

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    Authors
    Doherty, Glen A
    Cannon, Mary D
    Lynch, Karen M
    Ayoubi, Karim Z
    Harewood, Gavin C
    Patchett, Stephen E
    Murray, Frank E
    Affiliation
    Division of Gastroenterology and Hepatology, Beaumont Hospital, Royal College of Surgeons, Beaumont, Dublin, Ireland
    Issue Date
    2010-03
    MeSH
    Aged
    Aged, 80 and over
    Aspirin
    Attitude of Health Personnel
    Data Collection
    Female
    Gastrointestinal Hemorrhage
    Hospitals, Teaching
    Humans
    Male
    Middle Aged
    Peptic Ulcer
    Physician's Practice Patterns
    Platelet Aggregation Inhibitors
    Proton Pump Inhibitors
    Risk Factors
    Ticlopidine
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    Metadata
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    Citation
    Co-prescription of gastro-protectants in hospitalized patients: an analysis of what we do and what we think we do. 2010, 44 (3):e51-6 J. Clin. Gastroenterol.
    Journal
    Journal of clinical gastroenterology
    URI
    http://hdl.handle.net/10147/127500
    DOI
    10.1097/MCG.0b013e3181a9f43b
    PubMed ID
    19609216
    Abstract
    Proton pump inhibitors (PPIs) reduce the risk of upper gastrointestinal hemorrhage (UGIH) associated with the use of many medications.
    To examine how clinicians perceive such risk and whether PPI co-prescribing is based on an accurate assessment.
    Clinicians in a single teaching hospital were asked to estimate risk of UGIH and comment on PPI co-prescription in hypothetical patients. Records of 160 hospital in-patients (median age; 74 y) were then reviewed to examine PPI prescribing and risk factors for UGIH.
    In general, clinicians estimated UGIH risk accurately and reported low thresholds for PPI co-prescription. Prescribing records showed regular PPI use increased between admission and discharge of patients from 61/160 (38%) to 93/160 (58%). Ten percent had a prior history of peptic ulcer disease. Proton pump inhibitor prescription was significantly associated with the use of aspirin and clopidogrel. Half of the patients with multiple risk factors for UGIH on admission and almost a third at discharge were not co-prescribed a PPI.
    Clinicians generally estimate correctly the risk of UGIH and report a low threshold for prescribing gastro-protection. Despite this, prescribing practice does not consistently take account of relative risk of UGIH. Targeted PPI co-prescribing on the basis of risk factors would lead to more rational PPI use.
    Item Type
    Article
    Language
    en
    ISSN
    1539-2031
    ae974a485f413a2113503eed53cd6c53
    10.1097/MCG.0b013e3181a9f43b
    Scopus Count
    Collections
    Beaumont Hospital

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