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Copyright of Écrans is the property of Classiques Garnier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Écrans is the property of Classiques Garnier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Les antiagrégants plaquettaires (AAP) exposent à des risques d'hémorragie gastro-intestinale importants. Les inhibiteurs de la pompe à protons (IPP) semblent prévenir ce risque mais leur prise au long cours peut entraîner des effets indésirables et des coûts importants. L'identification des patients devant bénéficier d'une prévention est donc nécessaire. Il existe différentes recommandations quant à cette utilisation des IPP. L'objectif principal de cette étude était d'évaluer le respect des recommandations de gastro-protection par IPP pour les patients traités par AAP au centre hospitalo-universitaire de Rennes. L'objectif secondaire était d'étudier les facteurs associés aux prescriptions d'IPP. Pour tous les patients sous AAP le 05 juin 2019, la co-prescription d'un IPP a été recueillie, ainsi que des facteurs de risque connus d'hémorragie. Le respect des recommandations a été analysé ainsi que les facteurs associés à la prescription d'IPP. Parmi les 287 patients inclus, 126 (43,9 %) sont sous IPP. Lorsqu'un IPP est recommandé, il est bien prescrit dans 80 % des cas. Parmi les patients présentant d'autres facteurs de risque non couverts par les recommandations, 56,3 % n'ont pas d'IPP. Aucune justification n'est retrouvée pour 21 % des prescriptions d'IPP. Tous les patients ayant des antécédents d'hémorragie digestive ou un reflux gastro-œsophagien sont sous IPP. Les autres facteurs significativement associés à la prescription d'IPP sont la double anti-agrégation plaquettaire (OR : 4,71 [2,14-10,34]) et l'anticoagulation (OR : 2,92 [1,29-6,63]). Les critères définissant les sujets à risque mériteraient d'être précisés dans les recommandations nationales et les professionnels de santé sensibilisés à évaluer le rapport bénéfice risque des IPP. Antiplatelet agents expose to an important risk of gastro-intestinal bleeding. Proton pump inhibitors (PPI) seem to prevent this risk but their long-term use can be responsible of adverse effects and represents important costs. Identifying patients who would beneficiate of a PPI prevention is necessary. Different guidelines exist regarding this preventive use. The primary objective of this study was to evaluate the agreement of PPI prescriptions with the guidelines for patients treated with antiplatelet agents in Rennes' University hospital. The secondary objective was to analyze factors associated with PPI prescription. For all patients with an antiplatelet prescription on 05/06/2019, we searched for co-prescription of a PPI as well as other known bleeding risk factors. We analyzed the agreement with the guidelines as well as the factors associated with PPI prescription. Among the 287 patients included, 126 (43.9%) were treated with a PPI. National guidelines were well respected (>80%) when a PPI was recommended. However, 56.3% of patients presenting other bleeding risk factors, not mentioned in these guidelines, were not protected by a PPI. We found no justification for 21% of all PPI prescriptions. All patients with a history of gastro-intestinal bleeding or gastro-esophageal reflux disease were protected by a PPI. Other factors significantly associated with PPI prescription were dual antiplatelet therapy (OR: 4.71 [2.14-10.34]) and anticoagulation (OR: 2.92 [1.29-6.63]). The criteria which define patients at risk should be better specified in national guidelines. Health professionals should also be sensitized to evaluate the benefit risk ratio of PPI prescription. [ABSTRACT FROM AUTHOR]

Copyright of Lien Social et Politiques is the property of Institut National de Recherche Scientifique (INRS) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)