Prescription of Nonsteroidal Anti-inflammatory Drugs and Co-prescribed Drugs for Mucosal Protection: Analysis of the Present Status Based on Questionnaires Obtained from Orthopedists in Japan
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概要
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Objective Recently guidelines for the treatment and prevention of ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs) have been established. The aim of the present study was to examine factors influencing orthopedists in Japan in the use of cytoprotective drugs to prevent NSAID-associated gastrointestinal adverse events. Methods We sent a questionnaire to 402 orthopedists in Hyogo Prefecture. A standardized 10-item questionnaire was used to collect information on NSAID prescriptions (drug name, pharmaceutical form, doses, and duration of use) and associated drugs, especially gastroprotective drugs. Results Two hundred eight (51.7%) orthopedists returned the questionnaire. The most frequently used NSAIDs, in descending order, were loxoprofen sodium, diclofenac sodium, and etodolac. Most doctors (80%) reported patients with abdominal symptoms associated with NSAIDs. Of these doctors, 59% treated the symptoms by themselves, and prescribed gastroprotective agents (32.2%), histamine H2-receptor antagonists (H2RAs) (26.4%), prostaglandin analogues (PAs) (17.0%), or proton pump inhibitors (PPIs) (16.2%). Sixty-seven percent of doctors reported that those drugs reduced the symptoms. Most orthopedists (96%) prescribed some type of drug to prevent NSAID-associated gastrointestinal events, including gastroprotective drugs (44.6%), H2RAs (19.5%), PAs (17.4%), and PPIs (10.8%). The doctors reported that they prescribed medicines for NSAID-associated gastrointestinal events on the basis of their experience (23%), by considering medical insurance restrictions (17%), and by referring to information provided by pharmaceutical company representatives (16%). Conclusion Most orthopedists prescribe some type of drug to prevent NSAID-induced ulcers but do not refer to the guidelines. We therefore strongly recommend that the guidelines be made more widely known to gastroenterologists and to physicians in every field of clinical practice, including orthopedics.
著者
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Doita Minoru
Department Of Orthopaedic Surgery Kobe Graduate University School Of Medicine
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KUTSUMI Hiromu
Department of Gastroenterology, Kobe University School of Medicine
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Kutsumi Hiromu
Department Of Gastroenterology Kobe University Hospital
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Morita Yoshinori
Department Of Gastroenterology Graduate School Of Medicine Kobe University
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Inokuchi Hideto
Department Of Gastroenterology Graduate School Of Medicine Kobe University
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Azuma Takeshi
Department Of Gastroenterology Kobe University Graduate School Of Medicine
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Tamura Isamu
Department Of Gastroenterology Kobe University Graduate School Of Medicine
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Tsumura Hidetaka
Department Of Gastroenterology Kobe University Graduate School Of Medicine
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Kurosaka Masahiro
Department Of Orthopaedic Surgery Kobe University Faculty Of Medicine
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Tanaka Hiroshi
Department Of Analytical Chemistry Faculty Of Pharmaceutical Sciences Hoshi University
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Yoshida Masaru
Department of Biochemical Science,Faculty of Computer and Systems,Engineering,Kyushu Institute of Technology
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Shiomi Hideyuki
Department of Gastroenterology, Kobe University School of Medicine
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Inokuchi Hideto
Department of Gastroenterology, Kobe University School of Medicine
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Chinzei Ryo
Department of Gastroenterology, Kobe University School of Medicine
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Ishida Tsukasa
Department of Gastroenterology, Kobe University School of Medicine
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Masuda Atsuhiro
Department of Gastroenterology, Kobe University School of Medicine
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