Nonsteroidal antiinflammatory drug use among patients with GI bleeding

Kelli L. Dominick, Hayden B. Bosworth, Amy S. Jeffreys, Steven C. Grambow, Eugene Z. Oddone, Ronnie D. Horner

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


BACKGROUND: Previous studies have suggested that recommended gastroprotective strategies such as gastroprotective agents (GPAs) and cyclooxygenase (COX) 2 inhibitors may be underutilized among individuals at risk for nonsteroidal antiinflammatory drug (NSAID)-related gastrointestinal (GI) bleeding. OBJECTIVE: To examine the use of traditional NSAIDs, COX-2 inhibitors, and GPAs among patients recently hospitalized for GI bleeding. METHODS: This was a retrospective cohort study of a national sample of 4338 veterans hospitalized for GI bleeding between January and June 1999. Prescription drug use was examined for 6 months following hospitalization. We examined relationships of subject characteristics (age, race, gender, geographic region, diagnosis of arthritis) to prescription of a high-risk NSAID, defined as a traditional NSAID but no GPA within 60 days before or after the NSAID. RESULTS: Approximately 20% of subjects were prescribed an NSAID or COX-2 inhibitor, but only 5% were prescribed a traditional NSAID with no GPA. In a multivariable analysis, subjects <65 years of age and those with arthritis were more likely to be prescribed a traditional NSAID without a GPA. No other subject characteristics were related to receipt of a high-risk prescription. CONCLUSIONS: In a national sample of veterans with a recent hospitalization for GI bleeding, high-risk NSAID prescriptions were uncommon. Underuse of gastroprotective strategies may be more common in patients with less recent GI bleeding-related hospitalization. Strategies to remind physicians and pharmacists to screen for GI risk factors may help to sustain appropriate prescribing and reduce NSAID-related adverse events.

Original languageEnglish (US)
Pages (from-to)1159-1164
Number of pages6
JournalAnnals of Pharmacotherapy
Issue number7-8
StatePublished - Jul 2004
Externally publishedYes


  • Anti-ulcer agents
  • Nonsteroidal antiinflammatory drugs
  • Pharmacoepidemiology

ASJC Scopus subject areas

  • Pharmacology (medical)


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