Lanas A, Esplugues JV, Zapardiel J, Sobreviela E. Education-based approach to addressing non-evidence-based practice in preventing NSAID-associated gastrointestinal complications. World J Gastroenterol 2009; 15(47): 5953-5959 [PMID: 20014459 DOI: 10.3748/wjg.15.5953]
Corresponding Author of This Article
Dr. Angel Lanas, Service of Digestive Diseases, University Hospital, University of Zaragoza, Instituto Aragonés de Ciencias de la Salud (IACS), Centros de Investigación en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), C/San Juan Bosco 15, 50009 Zaragoza, Spain. alanas@unizar.es
Article-Type of This Article
Brief Article
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World J Gastroenterol. Dec 21, 2009; 15(47): 5953-5959 Published online Dec 21, 2009. doi: 10.3748/wjg.15.5953
Education-based approach to addressing non-evidence-based practice in preventing NSAID-associated gastrointestinal complications
Angel Lanas, Juan V Esplugues, Javier Zapardiel, Eduardo Sobreviela
Angel Lanas, Service of Digestive Diseases, University Hospital, University of Zaragoza, Instituto Aragonés de Ciencias de la Salud (IACS), Centros de Investigación en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), C/San Juan Bosco 15, 50009 Zaragoza, Spain
Juan V Esplugues, Department of Pharmacology, University of Valencia, CIBERehd, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
Javier Zapardiel, Department of Medical, AstraZeneca Farmacéutica Spain, Parque Norte, Edificio Roble, C/Serrano Galvache 56, 28033 Madrid, Spain
Author contributions: Lanas A designed the study, was responsible for the seminar content, had full access to the database, oversaw the analyses, interpreted the results and drafted the manuscript; Esplugues JV participated actively in the seminar process, the writing of the manuscript, and interpretation of the data and results; Zapardiel J contributed to the development of the protocol but had no role in the interpretation of the results; Sobreviela E was responsible for the database and provided the information and statistical analysis.
Supported by Unrestricted grant from AstraZeneca Spain
Correspondence to: Dr. Angel Lanas, Service of Digestive Diseases, University Hospital, University of Zaragoza, Instituto Aragonés de Ciencias de la Salud (IACS), Centros de Investigación en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), C/San Juan Bosco 15, 50009 Zaragoza, Spain. alanas@unizar.es
Telephone: +34-976-765786 Fax: +34-976-765787
Received: April 25, 2009 Revised: November 12, 2009 Accepted: November 19, 2009 Published online: December 21, 2009
Abstract
AIM: To evaluate an evidence-based educational program for improving strategies for prevention of nonsteroidal anti-inflammatory drug (NSAID)-associated gastrointestinal (GI) complications.
METHODS: Four hundred and fifty-six specialists replied to a questionnaire that covered issues related to NSAID-induced adverse effects. They also collected data from their last five consecutive patients before and after they had attended an evidence-based seminar on GI prevention strategies.
RESULTS: Four hundred and forty-one of 456 specialists (96.7%) participated in the survey, and 382 (83.7%) in the education-based study that recorded data from 3728 patients. The specialists overestimated the risk of GI complications with NSAIDs, underestimated the GI safety profile of coxibs, but were aware of the risk factors and of the current prevention strategies. Proton pump inhibitors were co-prescribed with NSAIDs in > 80% of patients with and without risk factors. The educational program had little impact on prescribing habits.
CONCLUSION: Specialists are informed of advances in NSAID-associated adverse effects and have high rates of GI-prevention therapy. Our educational program did not alter these rates.
