Evaluation of Drug Information Service Available for Physicians regarding Low-dose Aspirin-induced Gastrointestinal Lesions

• Published in: YAKUGAKU ZASSHI Vol. 134; no. 4; pp. 545 - 553
• Main Authors: Suzuki, Yuji, Yokoyama, Haruko, Soeda, Shinji, Tokuoka, Kentaro, Watanabe, Masayuki, Kitagawa, Yasuhisa, Yamada, Yasuhiko
• Format: Journal Article
• Language: English; Japanese
• Published: Japan The Pharmaceutical Society of Japan 01-04-2014
• Subjects: Administration, Oral; antiplatelet effect; Aspirin - administration & dosage; Aspirin - adverse effects; Drug Information Services; Drug Synergism; Gastrointestinal Diseases - chemically induced; gastrointestinal lesion; Humans; low-dose aspirin; physician; Surveys and Questionnaires
• ISSN: 0031-6903; 1347-5231
• DOI: 10.1248/yakushi.13-00193

Low-dose aspirin-induced gastrointestinal lesions are becoming an important problem in clinical practice. In our investigation of such adverse effects, we obtained 4 important findings considered useful for physicians, as follows; 1) even when aspirin was given at a dose, the incidence rate of gastrointestinal lesions was higher than with other non-steroidal anti-inflammatory drugs (NSAIDs), 2) the odds ratios for gastrointestinal lesions induced by aspirin with a histamine H2 receptor antagonist and proton pump inhibitor were 0.6 and 0.4, respectively, as compared with aspirin alone, 3) it is difficult to administer aspirin, which exerts an antiplatelet effect, without inducing gastrointestinal lesions, and 4) these gastrointestinal lesions appears early, especially within 2 years after administration. We distributed a questionnaire to 41 physicians to confirm our findings, and compared high (n=20) and low (n=21) frequency aspirin prescription groups. The recognition rate of points 1 and 3 noted above in the high group was significantly elevated as compared to the low group, whereas there no significant difference in regard to the information in point 4 between the groups and the rate of recognition was low. Moreover, only 27% of the surveyed physicians were familiar with all 4 points. Prior to receiving this information, 17% of the physicians gave no related instructions their patients, which was reduced to 0% after receiving this information. Furthermore, 98% of those surveyed found the information to be useful. Our results suggest that these 4 points of information regarding potential adverse gastrointestinal effects of low-dose aspirin are useful for physicians.