Education-based approach to addressing non-evidence-based practice in preventing NSAID-associated gastrointestinal complications

World J Gastroenterol. 2009 Dec 21;15(47):5953-9. doi: 10.3748/wjg.15.5953.


Aim: To evaluate an evidence-based educational program for improving strategies for prevention of nonsteroidal anti-inflammatory drug (NSAID)-associated gastrointestinal (GI) complications.

Methods: Four hundred and fifty-six specialists replied to a questionnaire that covered issues related to NSAID-induced adverse effects. They also collected data from their last five consecutive patients before and after they had attended an evidence-based seminar on GI prevention strategies.

Results: Four hundred and forty-one of 456 specialists (96.7%) participated in the survey, and 382 (83.7%) in the education-based study that recorded data from 3728 patients. The specialists overestimated the risk of GI complications with NSAIDs, underestimated the GI safety profile of coxibs, but were aware of the risk factors and of the current prevention strategies. Proton pump inhibitors were co-prescribed with NSAIDs in > 80% of patients with and without risk factors. The educational program had little impact on prescribing habits.

Conclusion: Specialists are informed of advances in NSAID-associated adverse effects and have high rates of GI-prevention therapy. Our educational program did not alter these rates.

Keywords: Adverse effects; Cyclooxygenase 2 inhibitors; Education; Gastrointestinal diseases; Nonsteroidal anti-inflammatory agents; Proton pump inhibitors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Education, Medical*
  • Evidence-Based Medicine / education*
  • Female
  • Gastrointestinal Diseases / chemically induced*
  • Humans
  • Middle Aged
  • Physicians
  • Practice Patterns, Physicians' / statistics & numerical data
  • Risk Factors
  • Surveys and Questionnaires


  • Anti-Inflammatory Agents, Non-Steroidal