Many Painkiller Users Not Protected Against Stomach Bleeding

A new study finds that less than a third of patients at high risk for gastrointestinal bleeding while taking NSAID painkillers are being prescribed medicines to prevent that bleeding.

NSAIDs include over-the-counter and prescription versions of aspirin, ibuprofen and naproxen (Aleve), as well as Vioxx and Bextra, which have been recalled, and Celebrex, which is still sold in the U.S.

According to ABC News, doctors have long recognized that long-term use of NSAIDs can raise risks for gastrointestinal bleeding, and guidelines exist to spot patients at high risk.  However, many doctors are not giving patients the medicines that can protect them against bleeding, according to study author Dr. Neena S. Abraham, a gastroenterologist at Baylor College of Medicine

NSAIDs are the most commonly prescribed drug in the United States, says Abraham, and upper gastrointestinal bleeding occurs in about 4.5 percent of patients who take NSAIDs over the long term.  Those most at risk for bleeding include people over 65, patients who take steroids or anti-coagulants with NSAIDs, and those who take painkillers in an amount exceeding the manufacturer’s recommended dosage.

In their study, Abraham and her colleagues looked at more than 300,000 patients treated throughout the county in 2002.  All were prescribed NSAIDs for pain relief, and would also be considered at high risk for upper gastrointestinal bleeding.  

Among patients with one or more risk factors, only about 27% were given therapy to counter the risk of bleeding, the researchers found.  Among patients with two or more risk factors, the number rose to 40% and therapeutic assistance reached a high of 42% for those with three or more risk factors for bleeding.

The results of the study appear in Gastroenterology 2005.

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