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Pharmacy World & Science

, Volume 30, Issue 6, pp 947–954 | Cite as

Pharmacist intervention reduces gastropathy risk in patients using NSAIDs

  • Victoria Ibañez-CuevasEmail author
  • Eduardo Lopez-Briz
  • M. Teresa Guardiola-Chorro
  • On behalf of the NSAID induced Gastropathy Prevention Programme Group
Research Article

Abstract

Objective To establish a detection and intervention strategy in order to reduce the number of non-steroidal anti-inflammatory drug (NSAIDs) users at risk of gastropathy from receiving either inadequate or no gastroprotection. Setting Community Pharmacies in Valencia, Spain. Method Prospective longitudinal intervention study without control group carried out by 79 Community Pharmacies. Patients over 18 who asked for any systemic NSAID were interviewed according to standard procedure. Pharmacist intervention was carried out when a patient at risk of serious NSAID-induced gastrointestinal complications due to inadequate or no gastric protection was identified. The doctor responsible was informed in order to then be able to assess the need to prescribe gastroprotection or change it if inadequate. In the case of over-the-counter (OTC) drugs, pharmacist intervention mainly involved replacing NSAIDs for safer medications. Main outcome measure Firstly, the number of patients who had no prescribed gastroprotection or inadequate gastroprotection was determined. Pharmacist intervention then brought about changes in pharmacotherapy in this situation. Results Of the 6,965 patients who asked for NSAIDs during the study period, 3,054 (43.9%) presented NSAID gastropathy risk factors. 35.6% of the latter (1,089) were not prescribed gastroprotection or were prescribed inadequate gastroprotection. Pharmacist intervention was carried out in 1,075 of these cases. On 391 occasions such risk situations were reported to doctors, who accepted pharmacist intervention on 309 occasions (79.0%) and then either prescribed gastroprotection (77% of cases); changed it (13.9%); withdrew the NSAID (5.8%) or substituted it (3.2%). 235 Pharmacist interventions took place when dispensing OTC NSAIDs. Conclusion Our strategy allowed us to identify a large number of patients who asked for NSAIDs in Community Pharmacies and who were at risk of NSAID gastropathy, as they received either inadequate gastroprotection or no gastroprotection whatsoever. Moreover, the pharmacist intervention carried out has reduced the number of these risk situations.

Keywords

Community pharmacists Drug counselling Gastrointestinal hemorrhage Non-steroidal anti-inflammatory drugs Risk factors Spain 

Notes

Acknowledgements

Authors would like to thank all the community pharmacists participating in the study (who are listed below) and especially Vicente Baixauli and Rosa Sanchis for their useful help in conducting the fieldwork, and to Marisa Guillen and JM de Paz for their statistical support.

Funding body

M. I. Colegio Oficial de Farmacéuticos de Valencia.

Conflict of interests

None

Community pharmacists members of “NSAID-induced Gastropathy Prevention Programme” Group (in alphabetical order)

Aguilar S, Alpuente M, Álvarez M, Andreu E, Anrubia A, Anrubia J, Arastell A, Aznar S, Baixauli V, Barrera MD, Bellod J, Bellver O, Bigné P, Boix C, Bosch MJ, Bosch A, Caballero B, Castelló MA, Centelles C, Climent MT, Colmeneo LL, Cortes C, Cruz A, Cubells R, Cuquerella MJ, Daríes C, De Luna EV, Devesa C, Escrivá I, Esteve MC, Fernández RM, Fernández A, Forriol H, Fuentes AJ, Fuster A, Gámez R, García MJ, García MI, García M, García E, Gil B, Gil MR, Giménez MC, Gimeno V, González V, Gorgues J, Granel P, Hernández R, Hernández R, Hernández MJ, Ibáñez M, Ibáñez M, Icardo MA, Jiménez Y, Juan C, Juan T, Just MJ, Lapiedra A, Llatas G, López MP, López J, López F, López MJ, López-Camacho C, Lozano C, Martí J, Mártir C, Menudé PM, Molina F, Mompó J, Moncholí A, Montañana E, Moran MC, Navarro V, Pastor Y, Peiró I, Pérez C, Pérez J, Pretel L, Puerta C, Raga JA, Ribelles A, Rodrigo MP, Rosado E, Salar L, Salmerón JÁ, Sánchez M, Sanchís R, Santonja A, Soler L, Soucase MJ, Tamarit L, Vallcanera JL, Velert J, Velert MM, Velilla C, Verdejo N, Vidal J, Vidal MD, Villamón MT, Vives R, Vives J, Yago AM, Zuriaga MF.

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Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Victoria Ibañez-Cuevas
    • 1
    • 2
    Email author
  • Eduardo Lopez-Briz
    • 3
  • M. Teresa Guardiola-Chorro
    • 1
  • On behalf of the NSAID induced Gastropathy Prevention Programme Group
  1. 1.Official College of PharmacistsValenciaSpain
  2. 2.M.I. Colegio Oficial de FarmacéuticosValenciaSpain
  3. 3.Department of PharmacyUniversity Hospital La FeValenciaSpain

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