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Title of Journal: J Gastroenterol

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Abbravation: Journal of Gastroenterology

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Springer Japan

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DOI

10.1007/bf00240265

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1435-5922

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Association between adherence to evidencebased gu

Authors: Hidetaka Tsumura Tsuyoshi Fujita Isamu Tamura Yoshinori Morita Masaru Yoshida Takashi Toyonaga Hidekazu Mukai Hideto Inokuchi Hiromu Kutsumi Takeshi Azuma
Publish Date: 2010/05/25
Volume: 45, Issue: 9, Pages: 944-951
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Abstract

Recently guidelines for the treatment and prevention of ulcers induced by nonsteroidal antiinflammatory drugs NSAIDs were established This study investigated the association between the current adherence to the guidelines and the incidence of gastric mucosal lesions caused by NSAIDsThis study included 254 NSAIDs users 128 regular and 126 ondemand users who had undergone upper gastrointestinal endoscopy The patients were characterized as high risk based on the following age 65 years or older history of peptic ulcers concurrent use of corticosteroids or anticoagulants and highdose NSAIDs use Adherence was defined as the prescription of NSAIDs with proton pump inhibitors prostaglandin analogues or highdose histamine 2 receptor antagonists in highrisk NSAIDs user The severity of gastric mucosal lesions was evaluated using the modified LANZA score MLSSeventynine 617 of the regular NSAIDs users and 65 516 of the ondemand NSAIDs users met our definition of highrisk patients Adherence in the regular NSAIDs users and ondemand NSAIDs users was 25 317 and 16 246 respectively The incidence of gastric mucosal lesions MLS ≧ 1 was significantly higher in the nonadherence group than in the adherence group for both regular NSAIDs users 593 vs 280 P = 001 and ondemand NSAIDs users 633 vs 250 P = 001 Gastric ulcers in the regular NSAIDs users were more frequently observed in the nonadherence group than in the adherence group 296 vs 40 P  001This study was supported by a grant for the Global COE Program “Global Center of Excellence for Education and Research on Signal Transduction Medicine in the Coming Generation” from the Ministry of Education Culture Sports Science and Technology of Japan TA

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