Suboptimal prescribing of proton-pump inhibitors in low-dose aspirin users: a cohort study in primary care

• Published in: BMJ open 2013-01, Vol.3 (7), p.e003044
• Main Authors: de Jong, Hilda J I, Korevaar, Joke C, van Dijk, Liset, Voogd, Eef, van Dijk, Christel E, van Oijen, Martijn G H
• Format: Article
• Language: English
• Subjects: Aspirin; Drug dosages; General practice / Family practice; Heart attacks; Physicians; Prescriptions; Primary care; Studies
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2013-003044

Objective Determine the adherence to recommendations of concomitant proton-pump inhibitor (PPI) treatment in regular low-dose of aspirin (LDASA) users, taking factors associated with the probability of receiving a PPI into account. Design Cohort study. Setting Data were obtained from 120 Dutch primary care centres participating in the Netherlands Information Network of Primary Care (LINH). Participants Patients 18 years and older who were regularly prescribed LDASA (30–325 mg) in 2008–2010 were included. Main outcome measures Regular medication use was defined as receiving each consecutive prescription within 6 months after the previous one. Based on national guidelines, we categorised LDASA users into low and high gastrointestinal (GI) risk. A multilevel multivariable logistic regression analysis was applied to identify patient characteristics that influenced on the probability of regular PPI prescriptions. Results We identified 12 343 patients who started LDASA treatment, of whom 3213 (26%) were at increased risk of GI complications. In this group, concomitant regular use of PPI was 46%, 36% did not receive PPI prescriptions and 18% obtained prescriptions irregularly (p