News
16-09-2013

Importance of proton pump inhibitors for heart patients underestimated

About half of the patients at increased risk for cardiovascular disease who are prescribed low doses of aspirin as a preventive measure and who are at high risk of severe gastrointestinal problems are not prescribed proton-pump inhibitors as recommended by the Dutch Expert Group on Medication Safety. These results are described in an article published by researchers from the Netherlands Institute for Health Services Research (NIVEL) and the universities of British Columbia and California in the scientific journal BMJ Open.

 
Patients at increased risk of cardiovascular disease are often prescribed low-dose aspirin as a preventive strategy. Aspirin does indeed lower the risk of cardiovascular disease but can also cause gastrointestinal side effects that may even result in stomach ulcers or bleeding. The elderly and people who have already had a stomach ulcer are often prescribed proton pump inhibitors in order to reduce these side effects and prevent further complications. This therapy has been recommended since 2009 in a guideline proposed by the Dutch Expert Group on Medication Safety.
 
Insufficient knowledge of recommendation
Research done within the Netherlands Primary Care Database (formerly known as LINH) has shown that in 2010, 46% of patients who were eligible for proton pump inhibitors used them. A further 36% were not prescribed proton pump inhibitors and 18% used them irregularly. This means that 54% are not being treated in accordance with the recommendation from the Expert Group. “The study was done just one year after the recommendation was introduced,” confirms NIVEL programme leader Joke Korevaar, “but it really does indicate that improvements have to be made.”
 
Netherlands Primary Care Database
This analyses used data from 84 general practices covering more than 335,000 patients. The practices record data on patient contacts, including diagnoses, number of consultations, interventions, prescriptions and referrals.
 
Funding
Astra Zeneca
 
Cooperating partners
The University of British Columbia
University of Californië