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Patient-reported adherence to coprescribed proton pump inhibitor gastroprotection in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis patients using nonsteroidal anti-inflammatory drugs

Authors Henriksson K, From J, Stratelis G

Received 4 July 2014

Accepted for publication 11 September 2014

Published 18 November 2014 Volume 2014:8 Pages 1611—1617

DOI https://doi.org/10.2147/PPA.S70651

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Johnny Chen

Kenneth Henriksson,1 Jesper From,2 Georgios Stratelis2

1Reuma City, Stockholm, 2AstraZeneca Nordic-Baltic, Södertälje, Sweden

Background: Patients with osteoarthritis (OA), rheumatoid arthritis (RA), or ankylosing spondylitis (AS) are commonly treated with nonsteroidal anti-inflammatory drugs (NSAIDs), sometimes with a concomitant gastroprotective proton pump inhibitor (PPI). The present study examines real-life patient adherence to PPIs when coprescribed with NSAIDs.
Methods: This retrospective medical record survey identified patients diagnosed with OA, RA, or AS who had PPIs coprescribed with NSAIDs for prevention of NSAID-associated gastrointestinal ulcers. Actual NSAID and PPI intake was retrospectively recorded using a self-reported questionnaire. Adherence to PPI treatment was assessed using descriptive statistics.
Results: In total, 96 patients (69% female, mean age 67 years, 72% OA, 16% RA, 12% AS) were included. The mean patient-reported adherence to coprescribed PPIs was 73%–81%. The percentage of patients with a self-reported adherence of ≤80% was 26%. No predictive factors for low adherence could be identified.
Conclusion: Despite doctors’ instructions to use PPIs concomitantly with NSAIDs, the mean patient-reported adherence to coprescribed PPIs in this population indicates a risk of a “gastroprotective treatment gap”. The patients’ adherence to gastroprotective PPIs for the prevention of NSAID-associated upper gastrointestinal ulcers can be improved.

Keywords:
patient adherence, proton pump inhibitors, nonsteroidal anti-inflammatory drugs, gastroprotection, osteoarthritis, self-reported questionnaires

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