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Research
Gastro-protective policy and the incidence of upper gastrointestinal bleeding
  1. Ali S Taha1,2,
  2. Claire Kelly2,
  3. Caroline McCloskey1,
  4. Theresa Craigen1,
  5. Wilson J Angerson3
  1. 1Department of Gastroenterology, University Hospital Crosshouse, Kilmarnock, Scotland, UK
  2. 2Department of Medicine, University of Glasgow, Kilmarnock, Scotland, UK
  3. 3The University Department of Surgery, University of Glasgow, Glasgow, Scotland, UK
  1. Correspondence to Dr Ali S Taha, Department of Gastroenterology, University Hospital Crosshouse, Kilmarnock, Scotland KA2 0BE, UK; Ali.taha1{at}btinternet.com

Abstract

Objectives In recent years, policies have been proposed in order to guide the safer use of non-steroidal anti-inflammatory drugs (NSAIDs) and antiulcer therapy. We aimed to investigate the incidence of upper gastrointestinal bleeding (UGIB) before and after the introduction of these policies, 2007–2009, in a well-defined population in southwest Scotland.

Methods All patients with non-variceal upper gastrointestinal bleeding (NV-UGIB), diagnosed at a single regional unit, were included. Total drugs prescribed in our population were noted, including antiulcer drugs, antithrombotic drugs and both cyclo-oxygenase-2 enzyme-selective and non-selective inhibiting NSAIDs.

Results The incidence, the number of cases per 100 000 population per annum, of NV-UGIB fell from 134.7 in 2007 to 125.1 in 2008, and to 90.3 cases in 2009 (p<0.001). There was also a significant rise in the use of non-selective NSAIDs, proton pump inhibitors and antithrombotic drugs.

Conclusions Although a cause-and-effect relationship cannot be fully proven, physician education through drug-use policies is associated with a drop in the incidence of NV-UGIB. This is relevant to the prevention of this common condition.

  • Gastrointestinal Bleeding
  • Bleeding Peptic Ulcer
  • Decision Analysis
  • Epidemiology

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