ATTITUDES ON THE PREVENTION OF MUCOSAL DAMAGE WHEN PRESCRIBING LOW DOSE ASPIRIN (LDA) / NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAID), AND YEARLY CHANGES IN FREQUENCY IN HEMORRHAGIC LDA / NSAID ULCERS

Abstract

Background and Aims : The prevention of mucosal damage by LDA/NSAID is an important concern for general clinical practitioners. Our purpose was to determine yearly changes in the frequency of hemorrhagic LDA/NSAID ulcers in 562 cases of hemorrhagic gastro-duodenal ulcers and practitioners' attitudes on the prevention of hemorrhagic LDA/NSAIDs ulcers. Methods : We investigated the change in frequency of LDA ulcers and NSAID ulcers among digestive-tract hemorrhagic ulcers encountered between 2000 and 2012. We additionally distributed a questionnaire to determine the attitudes of general clinical practitioners concerning prevention of these hemorrhagic ulcers. Results : In contrast to the number of NSAID ulcers, which has been growing yearly, the number of LDA ulcers has been declining since reaching a peak in 2005. LDA ulcers recently dropped to 4% of hemorrhagic ulcers. Results of our questionnaire showed that when NSAIDs are prescribed, gastro-mucosal protective agents are the most used medicines for hemorrhagic-ulcer prevention with 27.9% of physicians prescribing a proton pump inhibitor (PPI). When LDAs are prescribed, a PPI is the most used medicine with a higher rate of 45.3%. Conclusion : It can be considered that the use of PPIs for preventive treatment of LDA ulcers is steadily becoming more common and digestive-tract hemorrhage due to LDA is decreasing.