Press Releases: Southern California
October 16, 2003
Kaiser Permanente researchers develop computerized method to predict gastrointestinal bleeding caused by nonsteroidal anti-inflammatory drugs
PASADENA, California – Kaiser Permanente, Southern California researchers have validated an assessment tool utilizing demographic data and risk factors obtained from computerized databases to predict patients' likelihood of suffering gastrointestinal bleeding from taking nonsteroidal anti-inflammatory drugs (NSAIDs).
"This can be a very valuable tool for physicians to have a reliable way to predict which patients will be the most prone to gastrointestinal bleeding before NSAIDs are prescribed," said the study's author, Craig Cheetham, PharmD, MS, of the Pharmacy Outcomes Research Group, Kaiser Permanente, Southern California.
The study, which is published in the October issue of the Journal of Rheumatology, was conducted using computer records of patients who filled one or more prescriptions for a single NSAID over a nine-month period. Historical and risk factor data was obtained including the patients' age, gender, prior gastrointestinal (GI) bleeding, use of GI medications, use of steroids, and use of disease modifying antirheumatic drugs (DMARD). The assessment tool, called eSCORE, was based on a previous risk assessment model developed by researchers at Stanford University.
A total of 303,211 NSAIDs patients who met eligibility requirements were included in the study. Serious GI events had occurred in 302 patients, a rate of 0.68% (0.68 events per 100 patient years of exposure). All risk factors except DMARD use were associated with a significant increase in the GI event rate. Higher eSCORE points were associated with increased GI event rates.
NSAIDs are used primarily for the treatment of inflammation, mild to moderate pain, and fever. Specific uses include the treatment of headaches, arthritis, sports injuries, and menstrual cramps. Aspirin, which is also classified as an NSAID, is used to prevent the blood from clotting and also for the prevention of strokes and heart attacks. Many cold and allergy medications also contain NSAIDs.
"This study supports the concept that the rate of GI events can be predicted by a defined set of easily assessed patient criteria using the eSCORE," said Cheetham. "Categorizing patients by risk score can guide the physician to appropriate therapeutic options, with the potential of protecting patients at greatest risk for a GI event."
The study's other authors are Gerald Levy, MD, MBA, of the SCPMG Department of Medicine, Division of Rheumatology; and Michele Spence, PhD, of the Pharmacy Outcomes Research Group.
About Kaiser Permanente
Kaiser Permanente is America's leading integrated health plan. Founded in 1945, it is a nonprofit, group practice prepayment program with Southern California headquarters in Pasadena, California. Kaiser Permanente serves the health care needs of 3.3 million members in Southern California. Today it encompasses the nonprofit Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals and their subsidiaries, and the for-profit Southern California Permanente Medical Group. Kaiser Permanente's Southern California Region includes more than 49,900 technical, administrative and clerical employees and caregivers, and more than 6,000 physicians representing all specialties. More information about Kaiser Permanente can be found at kaiserpermanente.org.
