Hospital Physicians' Influence on Gastrointestinal Protection during Treatment with Non-Steroidal Anti-Inflammatory Drugs and Acetylsalicylic Acid and the Impact on Prescribing in Primary Care

BACKGROUND: The aim of this study was to describe the use of gastrointestinal (GI) protection before, during and after hospitalisation for elderly patients using NSAID or low-dose ASA. METHODS: This study included all elderly patients (75+) admitted to hospital in the period of 1(st) April 2010 to 31(st) March 2011 at Odense University Hospital, Denmark, who were regular users of NSAID or low-dose ASA before hospital admission, or had one of these drugs initiated during hospital stay. By using pharmacy dispensing data and a hospital-based pharmacoepidemiological database, the treatment strategy for the individual patients was followed across hospital stay. RESULTS: In total, 3,587 patients were included. Before hospital admission, 93 of 245 NSAID users (38.0%) and 597 of 1994 user of low-dose ASA (29.9%) had used GI protection. During hospital stay, use of GI protection increased to 75% and 33.9%, respectively. When hospital physicians initiated new treatment with NSAID or with low-dose ASA, 305 of 555 (55.0%) and 647 of 961 (67.3%) were initiated without concomitant use of GI protection. When hospital physicians initiated GI protection, 26.8–51.0% were continued in primary care after discharge. CONCLUSIONS: During hospital stay, the use of GI protection increases, but when new treatment with NSAIDs or low-dose ASA is initiated in hospital, the use of gastrointestinal protection is low. The low use of GI protection is carried on in primary care after discharge.