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

Abstract

BackgroundPatients 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.MethodsThis 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.ResultsIn 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.ConclusionDespite 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.

Dyspepsia in non‐steroidal anti‐inflammatory drug users and the effect of preventive measures

“…Approximately 63.2% (12/19) of those who had been given GPA and antacids in the present study reported that they did not adhere to the medication(s) for specific reasons. This figure is higher than those of two other studies that also employed direct patient‐reporting methods (16–27%) . A possible reason for this difference could be that the patients on regular NSAIDs in the other studies were mostly drawn from rheumatology or orthopedic sectors, whereas nearly 40% of the participants in the present study were drawn from primary care, where the main indication was acute musculoskeletal disorders.…”

“…33,34 A possible reason for this difference could be that the patients on regular NSAIDs in the other studies were mostly drawn from rheumatology or orthopedic sectors, whereas nearly 40% of the participants in the present study were drawn from primary care, where the main indication was acute musculoskeletal disorders. In addition, in the study by Henriksson et al 33 the doctors specifically instructed their patients to take the coprescribed proton pump inhibitor together with NSAIDs as part of the study procedures. Contrary to the study by Lanas et al 34 which reported that forgetfulness was the main reason for patients' nonadherence to GPA, the participants in the present study most commonly cited the absence of gastrointestinal symptoms as the reason.…”

“…A possible reason for this difference could be that the patients on regular NSAIDs in the other studies were mostly drawn from rheumatology or orthopedic sectors, whereas nearly 40% of the participants in the present study were drawn from primary care, where the main indication was acute musculoskeletal disorders. In addition, in the study by Henriksson et al . the doctors specifically instructed their patients to take the co‐prescribed proton pump inhibitor together with NSAIDs as part of the study procedures.…”

Bromelain: Methods of Extraction, Purification and Therapeutic Applications

“…NSAIDS are commonly prescribed in arthritis (Henriksson et al 2014). Bromelain can be used as harmless alternative and researchers have found that bromelain exhibits promising efficacy in arthritis (Osteoarthritis and rheumatoid arthritis) (Pavan et al 2012).…”

The Role of MicroRNAS in Ankylosing Spondylitis

“…1–6 It can lead to functional and structural impairments and reduction in quality of life. 7–10 The prevalence of AS is about 0.20% to 0.40% in China.…”