Lanas Angel, Plazas M A Josep, Gimeno Eva, Muñoz-Tudurí Marta
Service of Digestive Diseases, University Hospital, University of Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Centros de Investigación en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Zaragoza, Spain.
Gastroenterol Hepatol. 2012 Jan;35(1):1-7. doi: 10.1016/j.gastrohep.2011.10.004. Epub 2011 Dec 16.
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, multicentre 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.
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规定，高危患者应接受胃保护治疗。然而，不同的报告表明这些策略并未得到很好的执行。为了确定西班牙初级保健中NSAID和/或LDA使用者中减少胃肠道并发症的预防策略的使用情况，我们进行了一项观察性、横断面、多中心研究，西班牙的初级保健医生参与了该研究。从2009年1月至2009年5月，医生收集了符合入选标准的连续5例患者2008年最后一次就诊时的人口统计学、临床和治疗数据。进行多因素逻辑回归以确定所使用预防策略的独立预测因素。共有713名初级保健医生纳入了3357例患者：68%为NSAID使用者，19.1%为LDA使用者，12.9%为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%有一个危险因素，42.9%有两个或更多危险因素。预防策略的总体使用率为75.8%。胃保护的使用率随着危险因素数量增加而升高。在接受NSAIDs治疗的高危患者中，胃保护的未充分使用率较低，不像其他国家之前在初级保健层面所报告的那样明显。我们还发现LDA使用者中胃保护的使用率很高。
