Frequency of risk factors for gastro-intestinal bleeding in 9704 patients using non-steroid anti-inflammatory drugs (NSAID's), treated in general practice in 2005. and 2006

Abstract

Objective to assess the frequency of risk factors for gastro-intestinal (GI) bleeding in patients already using NSAID's prescribed in general practice (GP). Methods 150 doctors in GP health institutions were collecting data in 2005, and 2006 about risk factors for gastro-intestinal (GI) bleeding in their patients using NSAID's. Following risk factors were included: smoking, corticosteroid therapy, regular aspirin therapy, anticoagulant therapy, history of GI problems and excess alcohol consumption. Research technique: Face-to-face interview, in health institution. Over the period of one week, GPs kept records of treating patients using NSAID's. Duration of questionnaire: 8-10 minutes. Descriptive statistic methods were used for data analyzes. Results Age distribution of patients was: under 30y 373 (3.8%) patients, 30-45y 1521 (15.7%) patients, 46-60y 3655 (37.6%) patients, over 60y 3926 (40.4%) patients out of total 9704 patients - 4209 (43.4%) men, and 5495 (56.6%) women. The reason for use of NSAID's was: osteoarthritis in 5301 (54.6%) patients, arthritis in 2032 (20.9%) patients, other in 2371 (24.4 %) patients. Total number of patients with risk factors for GI bleeding was 7809 (80.5%).The frequency of particular risk factor was as follows: smoking in 2594 (33.2%) patients, history of GI problems in 1812 (23.2%) patients, regular aspirin therapy in 1329 (17%) patients, anticoagulant therapy in 662 (8.5%) patients and excess alcohol consumption in 587 (7.5%) patients. Conclusions Total number of patients with risk factors for GI bleeding was extremely high - 7809 (80.5%), smoking being the most widespread risk factor (33.2%) followed by history of gastro-intestinal problems. Most of the patients were over age of 60 (40.4%), which is the independent risk factor for GI bleeding. High frequency of GI risk factors in population of patients treated in general practice emphasize the need for possible protective measures (use of COX-2 selective drugs, concomitant use of NSAID's and inhibitors of proton pump-PPI) to reduce the risk for GI bleeding.