ArticleProceedings (Baylor University. Medical Center)2025
Physicians' attitudes toward gastroprotective strategies for nonsteroidal anti-inflammatory drug prescription.
Article in Proceedings (Baylor University. Medical Center), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Barriers to guideline implementation.Proceedings (Baylor University. Medical Center) · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: There is a paucity of information regarding providers' attitudes toward gastric-protective strategies with concurrent use of nonsteroidal anti-inflammatory drugs (NSAIDs). We aimed to assess gastric-protective strategies used upon prescribing NSAIDs and providers' awareness of societal guidelines for preventing NSAID-induced gastric complications. Methods: A standardized 10-item questionnaire was sent to all orthopedic providers in North Carolina and South Carolina. The survey design and refinement were based on a literature review, item generation, and small and large focus group discussions. Results: Forty-two orthopedists responded to the survey (response rate 16%). The most frequently used NSAIDs were meloxicam (79%), naproxen (69%), and ibuprofen (64%). NSAIDs were most commonly prescribed on an as-needed basis (52%), followed by <3 months (43%). The most common indications were degenerative arthritis (95%) and herniated disk (45%). Gastrointestinal adverse effects of NSAIDs were managed by discontinuing NSAID therapy (73%) or switching to a cyclooxygenase-2 (COX-2) inhibitor (40%). A small proportion were managed by referring to another physician (36%). Some clinicians prescribed gastric prophylaxis for patients at high risk for NSAID-induced gastric complications (24%). The academic setting was significantly associated with gastric prophylaxis and frequent assessment for NSAID-induced gastric adverse events. Providers with >20 years of experience showed similar trends. In low-risk patients, compliance with gastroprotective prophylaxis prescription was low (5%). Most providers were unaware of the societal guidelines for NSAID-induced gastric complications or the preventive strategies. Conclusion: Prescription of gastric-protective medications with concurrent NSAID therapy is relatively low among orthopedists. Academic setting and higher years of experience showed a significant trend toward more gastric-protective medication prescription, COX-2 inhibitor use, and frequent assessments for gastric adverse events when prescribing NSAID therapy. Provider education on the latest societal guidelines and computer-based alerts can increase compliance and assessment for NSAID-induced gastric complications and preventive strategies.
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