Gastroprotective Agent Underuse in High‐Risk Older Daily Nonsteroidal Anti‐Inflammatory Drug Users over Time. Issue 10 (3rd October 2014)

• Record Type: Journal Article
• Authors: Marcum, Zachary A.; Hanlon, Joseph T.; Strotmeyer, Elsa S.; Newman, Anne B.; Shorr, Ronald I.; Simonsick, Eleanor M.; Bauer, Douglas C.; Boudreau, Robert; Donohue, Julie M.; Perera, Subashan; the Health, Aging and Body Composition Study
• Is Part Of: Journal of the American Geriatrics Society. Volume 62:Issue 10(2014:Oct.)
• Page Start: 1923
• Page End: 1927
• Publication Date: 2014-10-03
• Subjects: Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.13066
• Languages: English
• ISSNs: 0002-8614

Abstract

<abstract abstract-type="main" id="jgs13066-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jgs13066-sec-0001" sec-type="section"> <title>Objectives</title> <p>To examine whether older adults taking nonsteroidal anti‐inflammatory drugs (NSAIDs) decreased the underuse of gastroprotective agents over time.</p> </sec> <sec id="jgs13066-sec-0002" sec-type="section"> <title>Design</title> <p>Before‐and‐after study.</p> </sec> <sec id="jgs13066-sec-0003" sec-type="section"> <title>Setting</title> <p>Health, Aging and Body Composition Study.</p> </sec> <sec id="jgs13066-sec-0004" sec-type="section"> <title>Participants</title> <p>Daily users of a NSAID (prescription and over the counter (OTC)) at visits in 2002–03 (preperiod; n = 404) and 2006–07 (postperiod; n = 172). The sample had a mean ± standard deviation age of 78.2 ± 2.7 at the preperiod visit and 81.9 ± 2.7 at the postperiod visit. The majority were white and female and had 12 or more years of education.</p> </sec> <sec id="jgs13066-sec-0005" sec-type="section"> <title>Measurements</title> <p>Underusers were defined as persons taking nonselective NSAIDs who were at risk of peptic ulcer disease (PUD; because of current warfarin or glucocorticoid use or history of PUD) and not using a proton pump inhibitor (PPI) or persons taking cyclooxygenase 2 (COX‐2) selective NSAIDs and aspirin who were at risk of PUD (having at least one risk factor) and not using a PPI.</p> </sec> <sec id="jgs13066-sec-0006" sec-type="section"> <title>Results</title> <p>Daily NSAID use decreased from 17.6% to 11.3% (<italic>P</italic> < .001), and gastroprotective agent underuse decreased from 23.5% to 15.1% (<italic>P</italic> = .008). Controlling for important covariates, having prescription insurance was somewhat protective against underuse in the preperiod (adjusted odds ratio (AOR) = 0.78, 95% confidence interval (CI) = 0.46–1.34; <italic>P</italic> = .37), but more so and significantly in the postperiod (AOR = 0.41, 95% CI = 0.18–0.93; <italic>P</italic> = .03). Having prescription insurance was more protective in the post‐ than in the preperiod (less gastroprotective agent underuse; adjusted ratio of OR = 0.53, 95% CI = 0.22–1.29; <italic>P</italic> = .16), but this increased protection was not statistically significant.</p> </sec> <sec id="jgs13066-sec-0007" sec-type="section"> <title>Conclusion</title> <p>In older daily NSAID users at high risk of PUD, having prescription insurance and adequate gastroprotective use was more common in the post‐ than in the preperiod.</p> </sec> </abstract>